| Christopher Jackson, LAC | |
|
105 Highway 9, Oxford, AR 72565-0096 | |
| (501) 315-3344 | |
| Not Available |
| Full Name | Christopher Jackson |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 105 Highway 9, Oxford, Arkansas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558545897 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | P1109067 (Arkansas) | Primary |
| 101Y00000X | Counselor | (Arkansas) | Secondary |
| Entity Name | Birch Tree Communities Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770733768 PECOS PAC ID: 5597749747 Enrollment ID: O20040615001261 |
| Mailing Address | Practice Location Address |
|---|---|
| Christopher Jackson, LAC Po Box 1589, Benton, AR 72018-1589 Ph: (501) 315-3344 | Christopher Jackson, LAC 105 Highway 9, Oxford, AR 72565-0096 Ph: (501) 315-3344 |
Gale Tinsman, Counselor Medicare: Not Enrolled in Medicare Practice Location: 105 Hwy 9, Oxford, AR 72565 Phone: 870-258-3305 Fax: 879-258-3244 | |
Holly Nottingham, Counselor Medicare: Not Enrolled in Medicare Practice Location: 105 Highway 9, Oxford, AR 72565 Phone: 501-315-3344 | |
Tayler Thomason, Counselor Medicare: Not Enrolled in Medicare Practice Location: 105 Highway 9, Oxford, AR 72565 Phone: 501-315-3344 | |
Allison Lukens, Counselor Medicare: Not Enrolled in Medicare Practice Location: 108 N 1st St, Oxford, AR 72565 Phone: 501-315-3344 | |
Merinda Jackson, LAC Counselor Medicare: Medicare Enrolled Practice Location: 105 Hwy 9, Oxford, AR 72565 Phone: 870-258-3244 |