| Carl-christian Andrew Jackson, MD | |
|
2 Dudley St Ste 190, Providence, RI 02905-3248 | |
| (401) 228-0623 | |
| (401) 868-2319 |
| Full Name | Carl-christian Andrew Jackson |
|---|---|
| Gender | Male |
| Speciality | Surgery - Pediatric Surgery |
| Location | 2 Dudley St Ste 190, Providence, Rhode Island |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235355173 | NPI | - | NPPES |
| 00A882720 | Medicaid | CA |
| Entity Name | Pratt Pediatric Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477590511 PECOS PAC ID: 3779475371 Enrollment ID: O20040329000127 |
| Entity Name | Pratt Surgical Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912944182 PECOS PAC ID: 4486546082 Enrollment ID: O20040329000139 |
| Mailing Address | Practice Location Address |
|---|---|
| Carl-christian Andrew Jackson, MD 15 Lasalle Square, Providence, RI 02903 Ph: (401) 444-3239 | Carl-christian Andrew Jackson, MD 2 Dudley St Ste 190, Providence, RI 02905-3248 Ph: (401) 228-0623 |
Aileen Hsueh, Surgery Medicare: Not Enrolled in Medicare Practice Location: 593 Eddy St, Providence, RI 02903 Phone: 401-444-8450 Fax: 401-444-5088 | |
Todd S Stafford, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 195 Collyer St Ste 302, Providence, RI 02904 Phone: 401-228-0633 Fax: 401-793-5171 | |
Dr. Robert Ira Wolf, MD Surgery Medicare: Medicare Enrolled Practice Location: 593 Eddy St, Providence, RI 02903 Phone: 401-444-5180 | |
Abigail Case, MD Surgery Medicare: Medicare Enrolled Practice Location: 593 Eddy St, Providence, RI 02903 Phone: 401-444-5180 | |
Dr. Carl Winkler, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 825 Chalkstone Ave, Providence, RI 02908 Phone: 212-523-4000 | |
Edward J. Marcaccio Jr., MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 2 Dudley St, Suite 470, Providence, RI 02905 Phone: 401-553-8318 Fax: 401-868-2307 | |
Marcy Ellen Bernstein, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 10 Dorrance St Ste 700, Providence, RI 02903 Phone: 954-399-4673 |