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General, Orthopedic, Thoracic, Vascular Surgery
Plastic, Cosmetic, Oral, Podiatric Surgery

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DR. JERRY S JACKSON DPM

Podiatric Medicine - Foot and Ankle Surgery

Montezuma, Kansas

Provider NPI: 1154423234

Provider Information:
DR. JERRY S JACKSON DPM


Practice Location:
300 AZTEC ST  MONTEZUMA, KS 67867 US
Tel: 855-259-9183  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y213E00000XPodiatric Medicine & Surgery Service Providers
Podiatrist
KS145
N213ES0000XPodiatric Medicine & Surgery Service Providers
Podiatrist
KS145
N213ES0103XPodiatric Medicine & Surgery Service Providers
Podiatrist
KS145

Other Provider Identifiers:

IssuerNumberStateType
1154423234MO05
100094110BMO05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin



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