| R. Elliott Jackson Geriatrics,llc | |
|
2650 Weigelia Rd Ne Atlanta GA 30345-3969 | |
| (404) 213-3672 | |
| (770) 458-1596 |
| Full Name | R. Elliott Jackson Geriatrics,llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2650 Weigelia Rd Ne, Atlanta, Georgia |
| Authorized Official Name and Position | Ramsey Elliott Jackson (OWNER) |
| Authorized Official Contact | 4042133672 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| R. Elliott Jackson Geriatrics,llc 3904 N Druid Hills Rd #222 Decatur GA 30033-3105 Ph: (770) 458-1594 | R. Elliott Jackson Geriatrics,llc 2650 Weigelia Rd Ne Atlanta GA 30345-3969 Ph: (404) 213-3672 |
| NPI Number | 1437261617 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 9436142692 |
|---|---|
| Medicare Enrollment ID | O20040405001323 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437261617 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 047774 (Georgia) | Primary |
| Provider Name | Ramsey E Jackson |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1275645459 PECOS PAC ID: 4789677840 Enrollment ID: I20040405001397 |
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