| Paul D Jackson, MD | |
|
508 Arnold Ave, Greenville, MS 38701-5319 | |
| (662) 335-4000 | |
| (662) 332-3867 |
| Full Name | Paul D Jackson |
|---|---|
| Gender | Male |
| Speciality | Obstetrics & Gynecology |
| Location | 508 Arnold Ave, Greenville, Mississippi |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053322974 | NPI | - | NPPES |
| P00386728 | Other | RR MEDICARE | |
| 00011234 | Medicaid | MS | |
| 1528005 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | 09542 (Mississippi) | Primary |
| Entity Name | Delta Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790701134 PECOS PAC ID: 6608775531 Enrollment ID: O20040108000636 |
| Mailing Address | Practice Location Address |
|---|---|
| Paul D Jackson, MD Po Box 23998, Jackson, MS 39225-3998 Ph: (662) 725-2749 | Paul D Jackson, MD 508 Arnold Ave, Greenville, MS 38701-5319 Ph: (662) 335-4000 |
James R Beckham, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 129 E Starling St, Suite C, Greenville, MS 38701 Phone: 662-725-1500 Fax: 662-725-1515 | |
Dr. Lakeisha White Richardson, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 302 Arnold Ave, Greenville, MS 38701 Phone: 662-335-2093 | |
Jack A Mcneil, M.D. Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 6 Orchard Pl, Greenville, MS 38701 Phone: 662-332-1463 |