Local City Search for Surgeons and Surgical Clinics 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:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 213E00000X | Podiatric Medicine & Surgery Service Providers Podiatrist | KS | 145 |
| N | 213ES0000X | Podiatric Medicine & Surgery Service Providers Podiatrist | KS | 145 |
| N | 213ES0103X | Podiatric Medicine & Surgery Service Providers Podiatrist | KS | 145 |
Other Provider Identifiers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 1154423234 | MO | 05 | |
| 100094110B | MO | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
