Dr Jackson Charles Graham, OD is a medicare enrolled "Optometrist" provider in West Siloam Springs, Oklahoma. His current practice location is
820 State Line Rd, West Siloam Springs, Oklahoma. You can reach out to his office (for appointments etc.) via phone at
(918) 422-5811.
Dr Jackson Charles Graham is licensed to practice in Oklahoma (license number 3224) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1497438493.
Healthcare Provider's Profile
| Full Name | Dr Jackson Charles Graham |
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| Gender | Male |
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| Speciality | Optometrist |
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| Location | 820 State Line Rd, West Siloam Springs, Oklahoma |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1497438493
- Provider Enumeration Date: 08/08/2023
- Last Update Date: 07/02/2025
Medicare PECOS Information:
- PECOS PAC ID: 3678926037
- Enrollment ID: I20240201001638
Medical Identifiers
Medical identifiers for Dr Jackson Charles Graham such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1497438493 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | 2894 (Arkansas) | Secondary |
| 152W00000X | Optometrist | 3224 (Oklahoma) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Jackson Charles Graham allows following entities to bill medicare on his behalf.
| Provider Name | Dr. Torrey J. Carlson & Associates |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1366480964
PECOS PAC ID: 2365401510
Enrollment ID: O20041005000363 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jackson Charles Graham is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Jackson Charles Graham, OD
Po Box 460,
Gentry, AR 72734-0460
Ph: (918) 931-2729 | Dr Jackson Charles Graham, OD
820 State Line Rd,
West Siloam Springs, OK 74338
Ph: (918) 422-5811 |
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