| Dr Mark K Jackson, MD | |
|
110 W 6th St, Oswego, NY 13126-2507 | |
| (315) 349-5000 | |
| Not Available |
| Full Name | Dr Mark K Jackson |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 37 Years |
| Location | 110 W 6th St, Oswego, New York |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063405538 | NPI | - | NPPES |
| 01880015 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 196101 (New York) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Chenango Memorial Hospital | Norwich, NY | Hospital |
| United Health Services Hospitals, Inc | Binghamton, NY | Hospital |
| Bassett Healthcare | Cooperstown, NY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| United Health Services Hospitals, Inc. | 5193610533 | 402 |
| Chenango Memorial Hospital Inc | 7517853633 | 92 |
| Entity Name | United Health Services Hospitals, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962463851 PECOS PAC ID: 5193610533 Enrollment ID: O20040216001017 |
| Entity Name | Delaware Valley Hospital Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144312646 PECOS PAC ID: 2860388337 Enrollment ID: O20040223001307 |
| Entity Name | Chenango Memorial Hospital Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770593956 PECOS PAC ID: 7517853633 Enrollment ID: O20040225000911 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Mark K Jackson, MD 104 W Utica St, Oswego, NY 13126-3031 Ph: (315) 343-0257 | Dr Mark K Jackson, MD 110 W 6th St, Oswego, NY 13126-2507 Ph: (315) 349-5000 |
Sudhir Babu Guthikonda, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 110 W 6th St, Oswego, NY 13126 Phone: 315-349-5541 |