| Jacksonville Chiropractic P. A. | |
|
1727 T P White Dr, Jacksonville, AR 72076-2861 | |
| (501) 985-7711 | |
| (501) 985-8385 |
| Full Name | Jacksonville Chiropractic P. A. |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 1727 T P White Dr, Jacksonville, Arkansas |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629258595 | NPI | - | NPPES |
| 5T401 | Other | AR | MEDICARE GROUP MEMBER PTAN |
| 5F994 | Other | AR | MEDICARE GROUP PTAN |
| U63233 | Other | AR | UPIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Blake Bennett |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1548234115 PECOS PAC ID: 2365524675 Enrollment ID: I20080125000235 |
| Mailing Address | Practice Location Address |
|---|---|
| Jacksonville Chiropractic P. A. 1727 T P White Dr, Jacksonville, AR 72076-2861 Ph: (501) 985-7711 | Jacksonville Chiropractic P. A. 1727 T P White Dr, Jacksonville, AR 72076-2861 Ph: (501) 985-7711 |
Dr. Blake W Bennett, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 1727 T P White Dr, Jacksonville, AR 72076 Phone: 501-985-7711 Fax: 501-985-8385 | |
Roman Ratycz, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 1120 John Harden Dr, Suite D, Jacksonville, AR 72076 Phone: 501-985-0056 Fax: 501-457-0021 |