Dr Keith Jackson, MD in Roswell, GA - Medicare Otolaryngology

Dr Keith Jackson, MD is a medicare enrolled "Otolaryngology" physician in Roswell, Georgia. He went to Medical College Of Georgia School Of Medicine and graduated in 1983 and has 43 years of diverse experience with area of expertise as Otolaryngology. He is a member of the group practice Professional Resources Management Of Rabun Llc and his current practice location is 1360 Upper Hembree Rd Ste 201b, Roswell, Georgia. You can reach out to his office (for appointments etc.) via phone at (770) 475-3361.

Dr Keith Jackson is licensed to practice in Georgia (license number 027575) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1225016454.

Contact Information

	Dr Keith Jackson, MD
	1360 Upper Hembree Rd Ste 201b, Roswell, GA 30076-1230
	(770) 475-3361
	Not Available

Map and Direction

Physician's Profile

Full Name	Dr Keith Jackson
Gender	Male
Speciality	Otolaryngology
Experience	43 Years
Location	1360 Upper Hembree Rd Ste 201b, Roswell, Georgia
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Keith Jackson attended and graduated from Medical College Of Georgia School Of Medicine in 1983

NPI Data:

NPI Number: 1225016454
Provider Enumeration Date: 01/06/2006
Last Update Date: 10/15/2019

Medicare PECOS Information:

PECOS PAC ID: 4183685530
Enrollment ID: I20041020000342

Medical Identifiers

Medical identifiers for Dr Keith Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1225016454	NPI	-	NPPES
00377539B	Medicaid	GA
00377539C	Medicaid	GA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Y00000X	Otolaryngology	027575 (Georgia)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Mountain Lakes Medical Center	Clayton, GA	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Professional Resources Management Of Rabun Llc	1052342854	12

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Keith Jackson allows following entities to bill medicare on his behalf.

Entity Name	Professional Resources Management Of Rabun Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1326191180 PECOS PAC ID: 1052342854 Enrollment ID: O20050822000836

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Keith Jackson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Keith Jackson, MD 12080 Wildwood Springs Dr, Roswell, GA 30075-1887 Ph: (770) 475-3361	Dr Keith Jackson, MD 1360 Upper Hembree Rd Ste 201b, Roswell, GA 30076-1230 Ph: (770) 475-3361

Reviews and Comments

Otolaryngology Doctors in Roswell, GA

Vivek V. Gurudutt, MD Otolaryngology Medicare: Medicare Enrolled Practice Location: 1360 Upper Hembree Rd, Suite 201b, Roswell, GA 30076 Phone: 770-475-3361 Fax: 770-664-4431
Dr. Andrew Diamond, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1360 Upper Hembree Rd, Suite 201, Roswell, GA 30076 Phone: 770-475-3361 Fax: 770-664-4431
Sunny Singh Khichi, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 2500 Hospital Boulevard, Suite 450, Roswell, GA 30076 Phone: 770-343-8675 Fax: 770-343-6297
Fiyin Sokoya, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1360 Upper Hembree Rd Ste 201b, Roswell, GA 30076 Phone: 770-475-3361
Dr. Yohan Song, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1360 Upper Hembree Rd Ste 101, Roswell, GA 30076 Phone: 770-225-1874 Fax: 678-254-0618
Kia Renee Jones, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1360 Upper Hembree Rd Ste 201b, Roswell, GA 30076 Phone: 770-475-3361 Fax: 770-664-4431

Dr Keith Jackson, MD - Medicare Otolaryngology in Roswell, GA