| Dr Christina A Jetton, MD | |
|
1430 W C St, Russellville, AR 72801-2805 | |
| (479) 968-6781 | |
| (479) 968-3074 |
| Full Name | Dr Christina A Jetton |
|---|---|
| Gender | Female |
| Speciality | Pathology - Anatomic Pathology & Clinical Pathology |
| Location | 1430 W C St, Russellville, Arkansas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205895745 | NPI | - | NPPES |
| 770158001 | Other | AR | BREASTCARE |
| 145744001 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | E2643 (Arkansas) | Primary |
| Entity Name | Pathology Services Laboratory Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831158369 PECOS PAC ID: 0840373411 Enrollment ID: O20080228000782 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Christina A Jetton, MD Po Box 925, Russellville, AR 72811-0925 Ph: (479) 968-6781 | Dr Christina A Jetton, MD 1430 W C St, Russellville, AR 72801-2805 Ph: (479) 968-6781 |
Dr. George Jenfu Wang, M.D. Pathology Medicare: Medicare Enrolled Practice Location: 1430 W C St, Russellville, AR 72801 Phone: 800-874-4904 | |
Vernon Anthony Harden, MD Pathology Medicare: Not Enrolled in Medicare Practice Location: 1430 West C Street, Russellville, AR 72801 Phone: 479-968-6781 Fax: 479-968-3074 | |
Gerald A Stolz Jr., MD Pathology Medicare: Not Enrolled in Medicare Practice Location: 1430 West C Street, Russellville, AR 72801 Phone: 479-968-6781 Fax: 479-968-3074 | |
Dr. Laura Marie Lowther, MD Pathology Medicare: Medicare Enrolled Practice Location: 1430 West C Street, Russellville, AR 72801 Phone: 479-968-6781 Fax: 479-968-3074 | |
Mr. Jorge F Jimenez, MD Pathology Medicare: Medicare Enrolled Practice Location: 1430 West C, Russellville, AR 72801 Phone: 479-968-6781 Fax: 479-968-3074 | |
Dr. James L Babcock, MD Pathology Medicare: Medicare Enrolled Practice Location: 1430 W C St, Russellville, AR 72801 Phone: 479-968-6781 |