CHARLES M JACKSON (NPI# 1255659082) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1255659082 |
Entity Type | Individual |
Full Name | CHARLES M JACKSON |
Credential | M.D. |
Practice Address |
2 East Appleby Rd. Suite 201 Fayetteville AR 72703 |
Mailing Address |
Po Box 550 Lowell AR 72745 |
Practice Telephone | 4794041100 |
Practice Fax Number | 4794041101 |
Mailing Telephone | 4794637775 |
Mailing Fax Number | 4794637187 |
Enumeration Date | 2010-05-04 |
Last Update Date | 2018-01-29 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208800000X | Urology | E-9270 | AR | Allopathic & Osteopathic Physicians |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457896839 | Charles Jackson | Counselor | 2911 Penick St, Shreveport, LA 71109-4337 | 2016-12-21 |
1043655681 | Charles D Jackson | Driver | 4856 W.12th, Suite 1, Cleveland, OH 44109-3424 | 2013-05-09 |
1437594553 | Charles Jackson | Social Worker | 18712 Quarry St, Riverview, MI 48193-4527 | 2013-05-02 |
1508154105 | Charles Gilbert Jackson Jr. | Psychiatry & Neurology | 88 Crescent St, Northampton, MA 01060-2115 | 2011-07-16 |
1457669848 | Charles Edward Jackson Jr. | Psychologist | 1407 Healing Water Lane, N.las Vegas, NV 89031 | 2010-09-20 |
1588994081 | Charles Dustin Jackson | Counselor | 5004 Nw 26th St, Oklahoma City, OK 73127-1722 | 2010-01-05 |
1508985250 | Charles Arthur Jackson Jr. | Chiropractor | 2455 E Hill Rd, Grand Blanc, MI 48439 | 2007-03-27 |
1760535926 | Charles Jackson | Podiatrist | 820 N Dalmont St, Hobbs, NM 88240-5214 | 2007-01-19 |
1982769840 | Charles Jackson | Dentist | 3540 82nd St, Jackson Heights, NY 11372-5159 | 2006-12-22 |
1437224813 | Charles Wesley Jackson Jr. | Psychologist | 2980 Washington Blvd, Cleveland Heights, OH 44118-2450 | 2006-11-21 |
Street Address |
2 EAST APPLEBY RD. SUITE 201 |
City | FAYETTEVILLE |
State | AR |
Zip Code | 72703 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003873050 | Richard D Mcwhorter | Urology | 2 East Appleby Rd., Suite 201, Fayetteville, AR 72703 | 2006-04-26 |
1174978985 | Lindsay D Horton | Nurse Practitioner | 2 East Appleby Rd., Suite 201, Fayetteville, AR 72703 | 2016-04-29 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477154391 | Margaret Sorrells | Pharmacist | 3909 N Mall Ave Attn:pharmacy, Fayetteville, AR 72703 | 2020-11-06 |
1497369631 | Justin A Rand | Massage Therapist | 88 W Colt Square Dr, Fayetteville, Ar 72703, Fayetteville, AR 72703 | 2020-09-04 |
1235777558 | Washington Regional Medical System | Specialist | 3264 N North Hills Blvd, Fayetteville, AR 72703 | 2019-12-17 |
1760024582 | Haley Brooke Thompson | Occupational Therapist | 2474 E Joyce Blvd Ste 2, Null, Fayetteville, AR 72703 | 2019-10-14 |
1306492129 | Bhg L, LLC | Clinic/Center | 8 Colt Square Drive, Fayetteville, AR 72703 | 2019-08-16 |
1306406269 | Idell Marie Mitchell | Optometrist | Eye Clinic, 1100 N College Ave, Fayetteville, AR 72703 | 2019-06-13 |
1821574815 | Toni Myer | Nurse Practitioner | 3 E Appleby Rd Ste 101, Fayetteville, AR 72703 | 2018-07-13 |
1306340393 | Josh Kelfer | Student in an Organized Health Care Education/Training Program | 1125 North College Avenue, Fayetteville, AR 72703 | 2018-03-22 |
1649726449 | Vantage Point of Nwa | Community/Behavioral Health | 4171 N. Crossover Rd, Fayetteville, AR 72703 | 2016-08-31 |
1386097137 | Jason Nordstrom | Speech-Language Pathologist | 2664 N Valencia Ave, Fayetteville, AR 72703 | 2016-07-18 |
Find all providers in zip 72703 |
Taxonomy Code | 208800000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Urology |
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679581003 | Carolina Lithotripsy Ldt | Urology | 2014 Litho Place, Fayetteville, NC 28304 | 2006-08-03 |
1003873050 | Richard D Mcwhorter | Urology | 2 East Appleby Rd., Suite 201, Fayetteville, AR 72703 | 2006-04-26 |
1881656924 | Fayetteville Urology Associates Pa | Urology | 1786 Metromedical Drive, Fayetteville, NC 28304 | 2006-04-04 |
1801860630 | Philip R Kreitzer | Urology | 4211 Medical Center Dr, Suite 211, Fayetteville, NY 13066-6637 | 2006-02-16 |
1861476897 | Nirmal K Kilambi | Urology | 1300 E Zion Rd, Fayetteville, AR 72703-5015 | 2005-12-02 |
1013912369 | Albert Vazquez Lugo | Urology | 7300 S Raeford Rd, Fayetteville, NC 28304-6162 | 2005-06-14 |
1124022561 | Henry Edward Parfitt Jr. | Urology | 1786 Metromedical Dr, Fayetteville, NC 28304-3861 | 2005-06-13 |
1861026619 | Georgia Urology Piedmont, LLC | Urology | 1336 Highway 54 W Bldg 200, Fayetteville, GA 30214-4574 | 2020-03-02 |
1548755903 | Cumberland County Hospital System Inc | Urology | 1537 Owen Park Ln, Fayetteville, NC 28304-3454 | 2018-06-28 |
1295122315 | Mark William Pickhardt | Urology | 3232 N Northhills Blvd, Fayetteville, AR 72703-4005 | 2015-04-16 |
Find all providers in FAYETTEVILLE |
City | FAYETTEVILLE |
Zip Code | 72703 |
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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.