JACKSON ONCOLOGY ASSOCIATES, PLLC (NPI# 1023147204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023147204 |
| Entity Type | Organization |
| Organization Name | JACKSON ONCOLOGY ASSOCIATES, PLLC |
| Practice Address |
2200 Highway 61 N Ste 3300 Vicksburg MS 39183-8246 |
| Mailing Address |
1227 N State St Ste 101 Jackson MS 39202-2002 |
| Practice Telephone | 6016383447 |
| Practice Fax Number | 6016309227 |
| Mailing Telephone | 6013552485 |
| Mailing Fax Number | 6013531463 |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2020-09-16 |
| Authorized Official Name | KIM WARD (CHIEF OPERATIONS OFFICER) |
| Authorized Official Telephone | 6019745513 |
| Is Organization Subpart | Y |
| Parent Organization Name | JACKSON ONCOLOGY ASSOCIATES, PLLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 03330910 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780713966 | Jackson Oncology Associates, Pllc | Internal Medicine | 1860 Chadwick Dr Ste 301, Jackson, MS 39204-3467 | 2007-03-05 |
| Street Address |
2200 HIGHWAY 61 N STE 3300 |
| City | VICKSBURG |
| State | MS |
| Zip Code | 39183-8246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306217823 | Tracy Curtis | Speech-Language Pathologist | 2100 Us 61, Vicksburg, MS 39183 | 2015-10-09 |
| 1649566894 | The Life Balance Clinic, Behavioral Health Service | Social Worker | 1107 B Openwood St., Vicksburg, MS 39183 | 2011-06-27 |
| 1245428788 | Melanie Joan Waldrop | Nurse Anesthetist, Certified Registered | 2100 Hwy 61n, River Region Medical Center, Vicksburg, MS 39183 | 2007-10-10 |
| 1871714477 | Robert Michael Coleman | Dentist | 2356 Grove Street, Vicksburg, MS 39183 | 2007-05-01 |
| 1942363502 | Visions Physical Therapy | Physical Therapist | 110 Holt Collier Dr, Vicksburg, MS 39183 | 2006-12-18 |
| 1023117991 | Janet S Fisher Dmd Pa | Dentist | 1212 Mission 66, Vicksburg, MS 39183 | 2006-09-21 |
| 1407878663 | Annette Bryant | Social Worker | 1107 Openwood St, Vicksburg, MS 39183 | 2006-07-24 |
| 1932168416 | Promise Hospital of Vicksburg Inc | Long Term Care Hospital | 2100 Highway 61 N Fl 6, Vicksburg, MS 39183 | 2006-03-22 |
| 1164945374 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2310 Clay St, Vicksburg, MS 39183 | 2017-07-19 |
| 1255777025 | Joyce Wanjugu Muruthi | Obstetrics & Gynecology | 2100 Highway 61 N, Vicksburg, MS 39183 | 2013-05-20 |
| Find all providers in zip 39183 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104821123 | Martin M Newcomb | Internal Medicine | 2368 Grove St, Vicksburg, MS 39183-2857 | 2005-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710365630 | Grenada Hematology Oncology LLC | Internal Medicine | 1300 Sunset Dr Ste F, Grenada, MS 38901-4083 | 2015-05-12 |
| 1720241201 | Jennifer T Eubanks | Internal Medicine | 1704 23rd Ave Fl 2, Meridian, MS 39301-3103 | 2008-07-06 |
| 1780713966 | Jackson Oncology Associates, Pllc | Internal Medicine | 1860 Chadwick Dr Ste 301, Jackson, MS 39204-3467 | 2007-03-05 |
| 1346379500 | Jackson Oncology Associates,pllc | Internal Medicine | 2969 Curran Dr N Ste 200, Jackson, MS 39216-4121 | 2007-03-05 |
| 1760585178 | Rose Cancer Center PC | Internal Medicine | 807 Robb Street, Summit, MS 39666 | 2006-09-07 |
| 1215960786 | Wail Alnas | Internal Medicine | 345 Baptist Blvd, Columbus, MS 39705 | 2006-07-08 |
| 1760415608 | Benton M Wheeler | Internal Medicine | 504 Azalea Dr Ste A, Oxford, MS 38655-5397 | 2006-07-07 |
| 1801825781 | Sonia M Benn | Internal Medicine | 7668 Airways Blvd, Southaven, MS 38671-5304 | 2006-07-02 |
| 1639119589 | Justin T Baker | Internal Medicine | 1227 N State St Ste 101, Jackson, MS 39202-2002 | 2006-06-08 |
| 1528023900 | Agustin J Suarez | Internal Medicine | 1513 Mcneill Steephollow Rd, Carriere, MS 39426-9168 | 2006-04-19 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.