| Lawrence Richard Jackson | |
|
102 Hillwood Dr Waverly TN 37185-2116 | |
| (931) 296-3555 | |
| (931) 296-9085 |
| Full Name | Lawrence Richard Jackson |
|---|---|
| Speciality | Family Medicine |
| Location | 102 Hillwood Dr, Waverly, Tennessee |
| Authorized Official Name and Position | Lawrence Richard Jackson (OWNER) |
| Authorized Official Contact | 9312963555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lawrence Richard Jackson Po Box 270 Waverly TN 37185-0270 Ph: (931) 296-3555 | Lawrence Richard Jackson 102 Hillwood Dr Waverly TN 37185-2116 Ph: (931) 296-3555 |
| NPI Number | 1104021203 |
|---|---|
| Provider Enumeration Date | 06/19/2007 |
| Last Update Date | 01/29/2008 |
| Medicare PECOS PAC ID | 1557350154 |
|---|---|
| Medicare Enrollment ID | O20040510000335 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104021203 | NPI | - | NPPES |
| 3724150 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Lawrence R Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386794816 PECOS PAC ID: 5698764298 Enrollment ID: I20090702000018 |
| Provider Name | Karen Michelle Dixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992569206 PECOS PAC ID: 9133566656 Enrollment ID: I20240320001203 |
King Family Medical Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 215b Holly Ln, Waverly, TN 37185 Phone: 931-296-9969 Fax: 931-296-8100 | |
Ascension Saint Thomas Three Rivers Primary Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 451 Highway 13 S, Waverly, TN 37185 Phone: 931-296-0211 Fax: 931-296-0199 | |
Waverly Clinic Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 806 E Main St, Waverly, TN 37185 Phone: 931-296-7788 Fax: 931-296-7130 | |
Chukwuogo Surgery Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 451 Highway 13 S, Waverly, TN 37185 Phone: 731-535-3099 Fax: 731-535-3123 | |
Dma Pediatrics And Specialty Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 300 S Clydeton Rd, Waverly, TN 37185 Phone: 615-446-5121 Fax: 615-446-1359 | |
Dickson Medical Associates, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 215b Holly Ln, Waverly, TN 37185 Phone: 931-296-9969 Fax: 931-296-8100 |