DR. COREY LAMONT JACKSON SR. (NPI# 1659419075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659419075 |
| Entity Type | Individual |
| Full Name | DR. COREY LAMONT JACKSON SR. |
| Credential | D.C. |
| Practice Address |
1518 S Poplar St Pine Bluff AR 71601-6249 |
| Mailing Address |
3615 W Hepburn St Pine Bluff AR 71603-2537 |
| Practice Telephone | 8705354878 |
| Practice Fax Number | 8708500199 |
| Mailing Telephone | 8706926618 |
| Mailing Fax Number | 8705400554 |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 1684 | AR | Chiropractic Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972873321 | Corey N Jackson | Contractor | 130 Mankin Pl, La Vergne, TN 37086-3048 | 2012-01-03 |
| 1215395637 | Corey Jackson | Health Educator | 100 Chambers St, Cumberland, RI 02864-7724 | 2016-01-30 |
| 1427432343 | Corey Jerrod Jackson | Registered Nurse | 601 Elmwood Ave, Rochester, NY 14642-0001 | 2015-07-10 |
| 1154735611 | Corey Jackson | Physical Therapist | 1551 N Rock Rd, Wichita, KS 67206-1255 | 2014-06-12 |
| 1558672881 | Corey E Jackson | Physical Therapist | 917 Beville Rd, Suite G, South Daytona, FL 32119-1712 | 2010-07-01 |
| 1669693032 | Corey Alan Jackson | Orthopaedic Surgery | 3373 Commerce Pkwy Ste 2, Wooster, OH 44691-7130 | 2007-05-01 |
| 1194866707 | Corey Jai Jackson | Counselor | 3995 Marcola Rd, Springfield, OR 97477-7948 | 2007-02-08 |
| Street Address |
1518 S POPLAR ST |
| City | PINE BLUFF |
| State | AR |
| Zip Code | 71601-6249 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902296353 | Porter Jackson IIi | Chiropractor | 1518 S Poplar St, Pine Bluff, AR 71601-6249 | 2015-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162863 | Kb's Adult Health Day Care Center | Clinic/Center | 2911 South Market Street, Pine Bluff, AR 71601 | 2020-10-19 |
| 1184244600 | Chelsea Briggs | Prosthetic/Orthotic Supplier | 601 S Main St Apt 514, Pine Bluff, AR 71601 | 2020-04-24 |
| 1407489081 | Katherine Bolden | Clinic/Center | 2911 East Market Street, Pine Bluff, AR 71601 | 2020-02-21 |
| 1851836829 | Rocky Mountain Holdings, LLC | Ambulance | 613b Hangar Row, Pine Bluff, AR 71601 | 2016-12-30 |
| 1316324494 | Nora Elizabeth Horton | Specialist/Technologist | 2003 University Drive, Suite 2, Pine Bluff, Ar, AR 71601 | 2015-04-28 |
| 1780003665 | Sameer R. Shelat | Internal Medicine | 4125, Rhinehart Road, Pine Bluff, AR 71601 | 2014-04-08 |
| 1700150471 | Community Empowerment Council, Inc. | Social Worker | 5830 Hwy 65 South, Pine Bluff, AR 71601 | 2012-02-28 |
| 1922243807 | The Pine Bluff Group, Pllc | Chiropractor | 2102 S. Olive St., Pine Bluff, AR 71601 | 2008-12-08 |
| 1053571711 | Jefferson Comprehensive Care System Inc | Clinic/Center | 1101 Tennssee, Pine Bluff, AR 71601 | 2008-06-16 |
| 1144404799 | The P.a.t. (people Advocating Transition) Center | Counselor | 620 South Laurel, Pine Bluff, AR 71601 | 2007-12-18 |
| Find all providers in zip 71601 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922243807 | The Pine Bluff Group, Pllc | Chiropractor | 2102 S. Olive St., Pine Bluff, AR 71601 | 2008-12-08 |
| 1972635886 | Dc Development Pa | Chiropractor | 2622 W 28th Ave, Pine Bluff, AR 71603 | 2007-03-09 |
| 1942341771 | Alexander Ashley Rejistre | Chiropractor | 121o West 5 Ave, Pine Bluff, AR 71601 | 2007-02-12 |
| 1679638449 | Michael Clay Stephens | Chiropractor | 2007 West 28th, Suite 1, Pine Bluff, AR 71603 | 2006-12-22 |
| 1235298886 | John M Glover | Chiropractor | 3016 W 28th Ave, Pine Bluff, AR 71603-4803 | 2006-12-08 |
| 1760424857 | M D Courtney | Chiropractor | 1421 S Cherry St, Pine Bluff, AR 71601-5621 | 2006-06-12 |
| 1326002312 | Jeffrey Harold Fergusson | Chiropractor | 3007 S Hazel St, Suite 2, Pine Bluff, AR 71603-5703 | 2006-04-14 |
| 1447245626 | Tommy Vance Ray Jr. | Chiropractor | 3415 Camden Rd, Pine Bluff, AR 71603-9082 | 2005-09-14 |
| 1902296353 | Porter Jackson IIi | Chiropractor | 1518 S Poplar St, Pine Bluff, AR 71601-6249 | 2015-01-23 |
| 1538433263 | Stephens Chiropractic Clinic Inc. | Chiropractor | 2007 West 28th, Suite 1, Pine Bluff, AR 71603 | 2012-02-27 |
| Find all providers in PINE BLUFF | ||||
| City | PINE BLUFF |
| Zip Code | 71601 |
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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.