| Kenneth G Jackson Jr, MD | |
|
885 Tiger Blvd, Clemson, SC 29631-1480 | |
| (864) 654-2067 | |
| (864) 653-5926 |
| Full Name | Kenneth G Jackson Jr |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 14 Years |
| Location | 885 Tiger Blvd, Clemson, South Carolina |
| 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 |
|---|---|---|---|
| 1801183710 | NPI | - | NPPES |
| 335603 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | LL33560 (South Carolina) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Kindred At Home | Greenville, SC | Home health agency |
| Anmed Health | Anderson, SC | Hospital |
| Prisma Health Oconee Memorial Hospital | Seneca, SC | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Anmed Health | 1951215243 | 223 |
| Entity Name | Anmed Health |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164746392 PECOS PAC ID: 1951215243 Enrollment ID: O20040315000478 |
| Entity Name | Anmed Health |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427005727 PECOS PAC ID: 1951215243 Enrollment ID: O20040723000885 |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth G Jackson Jr, MD Po Box 100174, Columbia, SC 29202-3174 Ph: (864) 512-5725 | Kenneth G Jackson Jr, MD 885 Tiger Blvd, Clemson, SC 29631-1480 Ph: (864) 654-2067 |
Edmond R Jordan, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 895 Tiger Blvd, Clemson, SC 29631 Phone: 864-654-6800 Fax: 864-654-7672 | |
Manju Lakra, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1011 Tiger Blvd, Suite 400, Clemson, SC 29631 Phone: 864-722-0283 Fax: 864-722-0261 | |
Robert Glen Quattlebaum, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 885 Tiger Blvd, Clemson, SC 29631 Phone: 864-512-7257 Fax: 864-654-3261 | |
Theodore Swann, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 386 College Ave, Clemson, SC 29631 Phone: 864-654-2067 Fax: 864-654-3261 | |
Renee A. Monaghan, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 895 Tiger Blvd, Clemson, SC 29631 Phone: 864-512-7527 Fax: 864-654-7672 | |
Ricardo C Hood, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1011 Tiger Blvd, Suite 400, Clemson, SC 29631 Phone: 864-722-0283 Fax: 888-376-4532 | |
Maria A Oliveira, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 735 Mcmillan Rd, Clemson, SC 29634 Phone: 864-656-2233 Fax: 864-656-0760 |