| Horace J Jackson Md Pc | |
|
464 Main Street Warsaw VA 22572 | |
| (804) 788-0556 | |
| Not Available |
| Full Name | Horace J Jackson Md Pc |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 464 Main Street, Warsaw, Virginia |
| Authorized Official Name and Position | Horace J Jackson (PRESIDENT OWNER) |
| Authorized Official Contact | 8047880556 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Horace J Jackson Md Pc 464 Main Street Warsaw VA 22572 Ph: (804) 788-0556 | Horace J Jackson Md Pc 464 Main Street Warsaw VA 22572 Ph: (804) 788-0556 |
| NPI Number | 1144466368 |
|---|---|
| Provider Enumeration Date | 12/17/2008 |
| Last Update Date | 12/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144466368 | NPI | - | NPPES |
| 006O49656 | Medicaid | VA | |
| 006954 | Other | VA | ANTHEM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |