| Jackson Podiatry, Inc | |
|
1201 Belmont Ave, Youngstown, OH 44504 | |
| (330) 333-3365 | |
| Not Available |
| Full Name | Jackson Podiatry, Inc |
|---|---|
| Type | Facility |
| Speciality | Podiatrist - Foot Surgery |
| Location | 1201 Belmont Ave, Youngstown, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306041744 | NPI | - | NPPES |
| 2736098 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213ES0131X | Podiatrist - Foot Surgery | 36003456 (Ohio) | Primary |
| Provider Name | Derrick O'neal Jackson |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1518080811 PECOS PAC ID: 8628169935 Enrollment ID: I20070801000039 |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Podiatry, Inc 1201 Belmont Ave, Youngstown, OH 44504-1101 Ph: (330) 333-3365 | Jackson Podiatry, Inc 1201 Belmont Ave, Youngstown, OH 44504 Ph: (330) 333-3365 |
Ankle And Foot Care Centers Podiatrist Medicare: Medicare Enrolled Practice Location: 5170 Belmont Ave, Youngstown, OH 44505 Phone: 330-759-1080 | |
Dr. Nathan Shane, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 8591 Crossroads Drive, Youngstown, OH 44514 Phone: 330-758-0577 Fax: 330-758-0466 | |
Louis Michael Chiaro, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 7629 Market Street, Suite 100, Youngstown, OH 44460 Phone: 330-332-5232 Fax: 330-332-4771 | |
Heather A. Petrolla Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 3507 Canfield Rd, Suite 7, Youngstown, OH 44511 Phone: 330-793-0566 Fax: 330-793-5767 | |
Ankle And Foot Care Centers Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 8175 Market St, Youngstown, OH 44512 Phone: 330-629-8800 Fax: 330-758-4914 | |
Angelo F. Petrolla Dpm Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 3507 Canfield Rd, Suite 7, Youngstown, OH 44511 Phone: 330-793-0566 Fax: 330-793-5767 | |
Ohio Podiatric Physicians And Surgeons Group, Llc Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 1265 Boardman Canfield Rd, Youngstown, OH 44512 Phone: 330-758-8808 Fax: 330-758-4288 |