| Leon S Jackson, MD | |
|
118 E Haskell St, Winnemucca, NV 89445-3247 | |
| (608) 788-8103 | |
| (608) 788-8799 |
| Full Name | Leon S Jackson |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 41 Years |
| Location | 118 E Haskell St, Winnemucca, Nevada |
| 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 |
|---|---|---|---|
| 1285622175 | NPI | - | NPPES |
| 100505784 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 11348 (Nevada) | Primary |
| 2085R0202X | Radiology - Diagnostic Radiology | G68430 (California) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Humboldt General Hospital | Winnemucca, NV | Hospital |
| Northern Nevada Medical Center | Sparks, NV | Hospital |
| Banner Lassen Medical Center | Susanville, CA | Hospital |
| Plumas District Hospital | Quincy, CA | Hospital |
| Renown Regional Medical Center | Reno, NV | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Humboldt General Hospital | 5193709798 | 43 |
| Sparks Radiology Group Ltd. | 8820077894 | 6 |
| Banner Health | 9537078365 | 20 |
| Plumas District Hospital | 8224930466 | 28 |
| Entity Name | William Bee Ririe Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487648804 PECOS PAC ID: 9335051747 Enrollment ID: O20031104000372 |
| Entity Name | Humboldt General Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922152784 PECOS PAC ID: 5193709798 Enrollment ID: O20040614000195 |
| Entity Name | Sparks Radiology Group Ltd. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992919237 PECOS PAC ID: 8820077894 Enrollment ID: O20040714001493 |
| Entity Name | Humboldt General Hospital |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1750498010 PECOS PAC ID: 5193709798 Enrollment ID: O20061104000361 |
| Entity Name | Northstar Radiology |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356768014 PECOS PAC ID: 7517284151 Enrollment ID: O20150319002350 |
| Entity Name | Banner Health |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427740570 PECOS PAC ID: 9537078365 Enrollment ID: O20230821001047 |
| Mailing Address | Practice Location Address |
|---|---|
| Leon S Jackson, MD 2031 32nd St S, La Crosse, WI 54601-7099 Ph: (608) 788-8103 | Leon S Jackson, MD 118 E Haskell St, Winnemucca, NV 89445-3247 Ph: (608) 788-8103 |
Robert Grierson Leckie, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 118 E Haskell St, Winnemucca, NV 89445 Phone: 775-623-5222 |