| Dr Jackson B Taylor, MD | |
| 200 Mercy Circle, Camp Pendleton, CA 92055-5191 | |
| (760) 719-3696 | |
| Not Available | 
| Full Name | Dr Jackson B Taylor | 
|---|---|
| Gender | Male | 
| Speciality | Surgery - Plastic And Reconstructive Surgery | 
| Location | 200 Mercy Circle, Camp Pendleton, California | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1487821559 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 2086S0122X | Surgery - Plastic And Reconstructive Surgery | 9901339 (North Carolina) | Primary | 
| 208200000X | Plastic Surgery | 9901339 (North Carolina) | Secondary | 
| Entity Name | Moses Cone Physician Services, Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1093953127 PECOS PAC ID: 4284782210 Enrollment ID: O20090501000202 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Jackson B Taylor, MD 4398 Stanford St, Carlsbad, CA 92010-7922 Ph: (757) 469-5474 | Dr Jackson B Taylor, MD 200 Mercy Circle, Camp Pendleton, CA 92055-5191 Ph: (760) 719-3696 | 
| Thanh Tuyen Thi Huynh, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: U.s. Naval Hospital, Camp Pendleton, CA 92055 Phone: 760-725-1356 | |
| Dr. Benjamin David Hoagland, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 200 Mercy Circle, Camp Pendleton, CA 92055 Phone: 760-725-1288 | |
| Augustus Gleason, MD Surgery Medicare: Medicare Enrolled Practice Location: 200 Mercy Circle, Department Of Surgery, Camp Pendleton, CA 92055 Phone: 760-725-1356 | |
| Dr. William Jason Butler, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 200 Mercy Circle, Dept Of Surgery, Camp Pendleton, CA 92055 Phone: 760-725-1288 | |
| Dr. Victoria Shoko Divis Mcdonald, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 200 Mercy Circle, General Surgery Clinic, Camp Pendleton, CA 92055 Phone: 760-725-1356 Fax: 760-725-0117 | |
| Dr. William Charles Brunner, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 200 Mercy Circle, Naval Hospital Camp Pendleton, Camp Pendleton, CA 92055 Phone: 760-725-1356 Fax: 760-725-0117 | |
| Oleg A Ryabinin, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 200 Mercy Circle, Camp Pendleton, CA 92055 Phone: 760-725-1356 |