| Jacksonville Medical Care | |
|
1300 Braden St. Jacksonville AR 72076-3719 | |
| (501) 985-5900 | |
| (501) 985-6016 |
| Full Name | Jacksonville Medical Care |
|---|---|
| Speciality | Family Medicine |
| Location | 1300 Braden St., Jacksonville, Arkansas |
| Authorized Official Name and Position | Gary Drew Jackson (CLINIC ADMINISTRATOR) |
| Authorized Official Contact | 5019855994 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacksonville Medical Care Po Box 309 Jacksonville AR 72078-0309 Ph: (501) 985-5900 | Jacksonville Medical Care 1300 Braden St. Jacksonville AR 72076-3719 Ph: (501) 985-5900 |
| NPI Number | 1396996740 |
|---|---|
| Provider Enumeration Date | 10/03/2008 |
| Last Update Date | 02/02/2011 |
| Medicare PECOS PAC ID | 8729142682 |
|---|---|
| Medicare Enrollment ID | O20090127000115 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396996740 | NPI | - | NPPES |
| 176116002 | Medicaid | AR | |
| 142734002 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| Provider Name | John Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720146509 PECOS PAC ID: 3779497540 Enrollment ID: I20031118000611 |
| Provider Name | Mark A Peterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407810898 PECOS PAC ID: 4587660980 Enrollment ID: I20061006000565 |
| Provider Name | Alan C Johnston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679579650 PECOS PAC ID: 5092879692 Enrollment ID: I20090127000201 |
| Provider Name | Robert R Ritchie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154327237 PECOS PAC ID: 2365506961 Enrollment ID: I20090127000238 |
| Provider Name | Miriam G. Morse |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033115639 PECOS PAC ID: 8729142328 Enrollment ID: I20090312000443 |
| Provider Name | Aaron D Roberds |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710306089 PECOS PAC ID: 6901122779 Enrollment ID: I20170913002030 |
| Provider Name | John D Wilkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396130431 PECOS PAC ID: 6204142482 Enrollment ID: I20181115001961 |
| Provider Name | Cameron Jacob Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053845651 PECOS PAC ID: 6002247392 Enrollment ID: I20200521001288 |
| Provider Name | Todd Firmatura |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326545401 PECOS PAC ID: 3870996978 Enrollment ID: I20210727003205 |
| Provider Name | Franchesca Schandevel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508253055 PECOS PAC ID: 1658677745 Enrollment ID: I20240319002426 |
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