| Jason Kelly Brockway, MD | |
|
1718 S Henderson Blvd, Kilgore, TX 75662-3566 | |
| (903) 983-2110 | |
| Not Available |
| Full Name | Jason Kelly Brockway |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 30 Years |
| Location | 1718 S Henderson Blvd, Kilgore, Texas |
| 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 |
|---|---|---|---|
| 1043283823 | NPI | - | NPPES |
| 752616977017 | Other | TX | TRICARE CHAMPUS |
| 113244106 | Medicaid | TX | |
| 117311 | Other | TX | SUPERIOR CHIPS |
| 081026902 | Medicaid | TX | |
| 752616977017 | Other | TX | TRICARE |
| 87581G | Other | TX | BCBS OF TEXAS |
| 113244103 | Medicaid | TX | |
| 117311 | Other | TX | CHIPS |
| 5411635 | Other | TX | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | K0427 (Texas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Christus Good Shepherd | Longview, TX | Home health agency |
| Christus Good Shepherd Medical Center | Longview, TX | Hospital |
| Christus Mother Frances Hospital | Tyler, TX | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Christus Trinity Clinic | 3072426741 | 1246 |
| Entity Name | Christus Trinity Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285684225 PECOS PAC ID: 3072426741 Enrollment ID: O20031204001091 |
| Entity Name | Mother Frances Hospital Jacksonville |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952306672 PECOS PAC ID: 5597751024 Enrollment ID: O20040421001092 |
| Entity Name | Mother Frances Hospital Regional Health Care Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679578439 PECOS PAC ID: 9234025636 Enrollment ID: O20040610001042 |
| Mailing Address | Practice Location Address |
|---|---|
| Jason Kelly Brockway, MD Po Box 846098, Dallas, TX 75284-6098 Ph: (903) 324-6450 | Jason Kelly Brockway, MD 1718 S Henderson Blvd, Kilgore, TX 75662-3566 Ph: (903) 983-2110 |
Kimberly Nicole Page, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1718 S Henderson Blvd, Kilgore, TX 75662 Phone: 903-983-2110 | |
Justin Levon Du, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1718 S Henderson Blvd, Kilgore, TX 75662 Phone: 903-983-2110 | |
John K. Wolcott, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 5174 Fm 1252 W, Kilgore, TX 75662 Phone: 903-986-1901 Fax: 903-984-6151 | |
Mark Douglas Miller, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1718 S Henderson Blvd, Kilgore, TX 75662 Phone: 903-983-2110 | |
Clark Wynn Langley, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1718 S Henderson Blvd, #8, Kilgore, TX 75662 Phone: 903-983-2110 | |
Dr. James E Repasky, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 1718 S Henderson Blvd, #7, Kilgore, TX 75662 Phone: 903-983-2110 |