| Dr Robert Wayne Jackson, DO | |
|
Sigler Ave, Memphis, MO 63555 | |
| (660) 465-2828 | |
| (660) 465-2820 |
| Full Name | Dr Robert Wayne Jackson |
|---|---|
| Gender | Male |
| Speciality | Rheumatology |
| Experience | 44 Years |
| Location | Sigler Ave, Memphis, Missouri |
| 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 |
|---|---|---|---|
| 1730293705 | NPI | - | NPPES |
| 241853779 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RR0500X | Internal Medicine - Rheumatology | R6C73 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Blessing Hospital | Quincy, IL | Hospital |
| Macon County Samaritan Memorial Hospital | Macon, MO | Hospital |
| Jefferson County Health Center | Fairfield, IA | Hospital |
| Pershing Memorial Hospital | Brookfield, MO | Hospital |
| Scotland County Hospital | Memphis, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Macon County Samaritan Hospital | 1456261395 | 31 |
| Blessing Hospital | 3072422534 | 369 |
| Kirksville Specialty Clinic Llc | 3476983370 | 3 |
| Van Buren County Hospital | 7214829530 | 27 |
| Sullivan County Memorial Hospital | 7810973252 | 17 |
| Pike County Memorial Hospital | 8123015518 | 29 |
| Scotland County Memorial Hospital | 8224940366 | 26 |
| Entity Name | General John J Pershing Memorial Hospital Association |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982612461 PECOS PAC ID: 2860306750 Enrollment ID: O20031117000114 |
| Entity Name | Macon County Samaritan Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548215106 PECOS PAC ID: 1456261395 Enrollment ID: O20040121000179 |
| Entity Name | Carroll County Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528067113 PECOS PAC ID: 2860485638 Enrollment ID: O20040407000120 |
| Entity Name | Sullivan County Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063553642 PECOS PAC ID: 7810973252 Enrollment ID: O20040626000444 |
| Entity Name | Pike County Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205837218 PECOS PAC ID: 8123015518 Enrollment ID: O20050214000278 |
| Entity Name | Pike County Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124030424 PECOS PAC ID: 8123015518 Enrollment ID: O20050407000376 |
| Entity Name | General John J Pershing Memorial Hospital Association |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487616256 PECOS PAC ID: 2860306750 Enrollment ID: O20050422000230 |
| Entity Name | Pike County Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437265311 PECOS PAC ID: 8123015518 Enrollment ID: O20070410000136 |
| Entity Name | Blessing Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114471737 PECOS PAC ID: 3072422534 Enrollment ID: O20171221000766 |
| Entity Name | Kirksville Specialty Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386126308 PECOS PAC ID: 3476983370 Enrollment ID: O20200416001776 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Robert Wayne Jackson, DO Sigler Ave, R1 Box 54, Memphis, MO 63555 Ph: (660) 465-2828 | Dr Robert Wayne Jackson, DO Sigler Ave, Memphis, MO 63555 Ph: (660) 465-2828 |
Shane Charles Wilson, DO Rheumatology Medicare: Accepting Medicare Assignments Practice Location: 450 E Sigler Ave, Ste A, Memphis, MO 63555 Phone: 660-465-2828 Fax: 660-465-2956 |