| James W Jackson Jr, MD | |
|
120 Executive Park, Louisville, KY 40207 | |
| (502) 855-7200 | |
| (502) 855-7201 |
| Full Name | James W Jackson Jr |
|---|---|
| Gender | Male |
| Speciality | Pain Management |
| Experience | 23 Years |
| Location | 120 Executive Park, Louisville, Kentucky |
| 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 |
|---|---|---|---|
| 1063583268 | NPI | - | NPPES |
| 719905 | Other | KY | WELLCARE OF KY PROVIDER ID |
| 002903176 | Other | UNITED HEALTHCARE PROVIDER ID NUMBER | |
| 9121168 | Other | AETNA PIN | |
| 200872860 | Medicaid | IN | |
| 000000858929 | Other | ANTHEM PIN | |
| 7100003940 | Medicaid | KY | |
| CS1434500725 | Other | CARESOURCE ID | |
| 135386KYIP | Other | KY | AETNA BETTER HEALTH OF KY PROVIDER ID NUMBER |
| Facility Name | Location | Facility Type |
|---|---|---|
| Hardin Memorial Hospital | Elizabethtown, KY | Hospital |
| Norton Hospitals, Inc | Louisville, KY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Commonwealth Pain Associates Pllc | 0941441919 | 131 |
| Pt Pros, Inc | 0143139337 | 218 |
| Commonwealth Pain Associates Pllc | 0941441919 | 131 |
| Entity Name | Commonwealth Pain Associates Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306280177 PECOS PAC ID: 0941441919 Enrollment ID: O20130802000577 |
| Mailing Address | Practice Location Address |
|---|---|
| James W Jackson Jr, MD Po Box 21890, Belfast, ME 04915-4115 Ph: (502) 907-0356 | James W Jackson Jr, MD 120 Executive Park, Louisville, KY 40207 Ph: (502) 855-7200 |
Kari Beth Christie, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 530 S Jackson St, Louisville, KY 40202 Phone: 502-852-5851 | |
Blake Evans, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 120 Executive Park, Louisville, KY 40207 Phone: 502-855-7200 Fax: 502-855-7201 | |
Peter S Lansing, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 4000 Kresge Way, Louisville, KY 40207 Phone: 502-259-5391 Fax: 502-259-9733 | |
Dr. Mahesh Agrawal, M.D. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 332 W Broadway, Suite 810, Louisville, KY 40202 Phone: 502-583-0909 | |
Dr. Kavita Mehta, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 233 E Gray St, Louisville, KY 40202 Phone: 502-629-2880 | |
Richard Booth Harris, D.O. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1850 Bluegrass Ave, Louisville, KY 40215 Phone: 502-361-6617 Fax: 502-361-6637 | |
Dr. Randall Joshua Campbell, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1 Audubon Plaza Dr, Attn: Ruby Poltner, Louisville, KY 40217 Phone: 502-636-7160 |