| Professional Health Services Of Jackson | |
|
233 Oil Well Rd Ste E Jackson TN 38305-8014 | |
| (731) 660-8467 | |
| (731) 660-8495 |
| Full Name | Professional Health Services Of Jackson |
|---|---|
| Speciality | Social Worker |
| Location | 233 Oil Well Rd Ste E, Jackson, Tennessee |
| Authorized Official Name and Position | H Warren Cole (CEO/OWNER) |
| Authorized Official Contact | 7316608467 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Health Services Of Jackson 233 Oil Well Rd Ste E Jackson TN 38305-8014 Ph: (731) 660-8467 | Professional Health Services Of Jackson 233 Oil Well Rd Ste E Jackson TN 38305-8014 Ph: (731) 660-8467 |
| NPI Number | 1407951684 |
|---|---|
| Provider Enumeration Date | 09/13/2006 |
| Last Update Date | 02/20/2009 |
| Medicare PECOS PAC ID | 7416929344 |
|---|---|
| Medicare Enrollment ID | O20080228000357 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407951684 | NPI | - | NPPES |
| 556710000 | Other | TN | MAGELLAN BEHAVIORAL HEALT |
| 3382556 | Medicaid | TN | |
| 3926019 | Medicaid | TN | |
| 7567489 | Other | TN | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Frank T Chin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447285317 PECOS PAC ID: 0648257014 Enrollment ID: I20040702000584 |
| Provider Name | Seth Doyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386096329 PECOS PAC ID: 1052606084 Enrollment ID: I20160830000214 |
| Provider Name | Indria Clay |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649315201 PECOS PAC ID: 2264666270 Enrollment ID: I20171011001264 |
| Provider Name | Brittany Holmes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366215345 PECOS PAC ID: 3779930425 Enrollment ID: I20231117000446 |
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