| East Texas Medical Center Jacksonville | |
|
1325 N Dickinson Dr Rusk TX 75785-1051 | |
| (903) 683-3600 | |
| (903) 683-3692 |
| Full Name | East Texas Medical Center Jacksonville |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 1325 N Dickinson Dr, Rusk, Texas |
| Authorized Official Name and Position | Jack R Endres (ADMINISTRATOR) |
| Authorized Official Contact | 9035415100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East Texas Medical Center Jacksonville 501 S Ragsdale St Jacksonville TX 75766-2434 Ph: (903) 541-5100 | East Texas Medical Center Jacksonville 1325 N Dickinson Dr Rusk TX 75785-1051 Ph: (903) 683-3600 |
| NPI Number | 1972827822 |
|---|---|
| Provider Enumeration Date | 03/22/2010 |
| Last Update Date | 10/31/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972827822 | NPI | - | NPPES |
| 283515901 | Medicaid | TX | |
| 283515902 | Other | TX | THSTEPS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Kendra Verhelle Md Community Medical Care Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 163 W 5th St, Rusk, TX 75785 Phone: 903-683-6619 Fax: 903-683-1176 | |
Jacksonville Hospital Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1325 N Dickinson Dr, Rusk, TX 75785 Phone: 903-583-3600 Fax: 903-583-3595 | |
John C Peyton Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1400 Hwy 84 West, Suite 6, Rusk, TX 75785 Phone: 903-683-1825 Fax: 903-683-1556 |