| Frederick John Jaecklein, MD | |
|
1211 Union Ave Ste 300, Memphis, TN 38104-6655 | |
| (901) 272-6018 | |
| (901) 201-4203 |
| Full Name | Frederick John Jaecklein |
|---|---|
| Gender | Male |
| Speciality | Vascular Surgery |
| Experience | 16 Years |
| Location | 1211 Union Ave Ste 300, Memphis, Tennessee |
| 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 |
|---|---|---|---|
| 1215343553 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2086S0129X | Surgery - Vascular Surgery | 63733 (Tennessee) | Primary |
| 2086S0129X | Surgery - Vascular Surgery | 4301095037 (Michigan) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Methodist Healthcare Memphis Hospitals | Memphis, TN | Hospital |
| Methodist Healthcare - Olive Branch Hospital | Olive branch, MS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Ut Methodist Physicians Llc | 2769623669 | 103 |
| Entity Name | Ut Methodist Physicians Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427317908 PECOS PAC ID: 2769623669 Enrollment ID: O20130718000263 |
| Mailing Address | Practice Location Address |
|---|---|
| Frederick John Jaecklein, MD 1211 Union Ave Ste 330, Memphis, TN 38104-6655 Ph: () - | Frederick John Jaecklein, MD 1211 Union Ave Ste 300, Memphis, TN 38104-6655 Ph: (901) 272-6018 |
Leonard Harvey Hines, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 6005 Park Ave, Suite 821-b, Memphis, TN 38119 Phone: 901-726-1056 Fax: 901-726-5867 | |
Dr. Robert D Wallace, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1068 Cresthaven Rd Ste 500, Memphis, TN 38119 Phone: 901-866-8525 | |
Dr. Dan Huff Shell Iii, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1068 Cresthaven Rd Ste 200, Memphis, TN 38119 Phone: 901-761-4844 Fax: 901-761-6929 | |
Randall William Franz, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1325 Eastmoreland Ave Ste 365, Memphis, TN 38104 Phone: 901-272-6018 Fax: 901-201-4203 | |
Dr. Christine T Mroz, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 6005 Park, #700, Memphis, TN 38119 Phone: 901-527-3391 Fax: 901-578-3969 | |
Miriam Wing San Tsao, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 1211 Union Ave Suite 300, Memphis, TN 38104 Phone: 901-516-0792 Fax: 901-266-6415 | |
Dr. Jonathan J Ellichman, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 6401 Poplar Ave Ste 410, Memphis, TN 38119 Phone: 901-259-2718 Fax: 901-259-1123 |