| Mark A Jackson, MD | |
|
1000 Pavilions Circle, Mark A Jackson Md Plc, Traverse City, MI 49684 | |
| (231) 935-0913 | |
| (231) 935-0984 |
| Full Name | Mark A Jackson |
|---|---|
| Gender | Male |
| Speciality | Family Medicine - Geriatric Medicine |
| Location | 1000 Pavilions Circle, Traverse City, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073585238 | NPI | - | NPPES |
| 1820487 | Medicaid | MI | |
| 080B86010 | Other | MA | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 051555 (Michigan) | Secondary |
| 207QG0300X | Family Medicine - Geriatric Medicine | 4301051555 (Michigan) | Primary |
| Entity Name | Northstar Palliative Care Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033638077 PECOS PAC ID: 6800148677 Enrollment ID: O20181004002356 |
| Mailing Address | Practice Location Address |
|---|---|
| Mark A Jackson, MD 10850 E Traverse Hwy, Ste 4400, Traverse City, MI 49684-1364 Ph: (231) 346-6930 | Mark A Jackson, MD 1000 Pavilions Circle, Mark A Jackson Md Plc, Traverse City, MI 49684 Ph: (231) 935-0913 |
Satya Pillay, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1400 Medical Campus Dr, Traverse City, MI 49684 Phone: 231-935-8000 Fax: 231-935-8099 | |
Samantha K Windle, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1400 Medical Campus Dr, Traverse City, MI 49684 Phone: 231-935-8000 Fax: 231-935-8099 | |
Dr. Donald James Aiken, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 16544 Wrightwood Terrace Dr, Traverse City, MI 49686 Phone: 231-223-7465 | |
Kaitlyn Lee Kilpatrick, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1400 Medical Campus Dr, Traverse City, MI 49684 Phone: 231-935-8000 Fax: 231-935-8099 | |
David J Wilcox, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 906 Business Park Dr, Traverse City, MI 49686 Phone: 800-968-6866 | |
Gary Stephen Ruoff, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 201 South Garfield Ave, Traverse City, MI 49686 Phone: 231-935-0580 Fax: 231-935-0584 |