JACKSON ENT CLINIC , PSC (NPI# 1831225465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1831225465 |
Entity Type | Organization |
Organization Name | JACKSON ENT CLINIC , PSC |
Practice Address |
1550 Highway 15 S Ste 29 Jackson KY 41339-9221 |
Mailing Address |
Po Box 768 Jackson KY 41339-0768 |
Practice Telephone | 6066669909 |
Practice Fax Number | 6066669982 |
Mailing Telephone | 6066669909 |
Mailing Fax Number | 6066669982 |
Enumeration Date | 2007-02-26 |
Last Update Date | 2008-11-14 |
Authorized Official Name | DR. TARIQ A SARTAWI (OWNER) |
Authorized Official Telephone | 6066669909 |
Authorized Official Credential | M.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 204E00000X | Oral & Maxillofacial Surgery | 36227 | KY | Allopathic & Osteopathic Physicians |
Y | 207Y00000X | Otolaryngology | 36227 | KY | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
KY | SA64023724 | 05 |
Street Address |
1550 HIGHWAY 15 S STE 29 |
City | JACKSON |
State | KY |
Zip Code | 41339-9221 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841890662 | Angela Shawn Bradley | Pharmacist | 1589 Ky Hwy 15 South, Jackson, KY 41339 | 2020-10-30 |
1871191734 | Ranita Greer | Pharmacist | 59 Ky-15 N, Jackson, KY 41339 | 2020-10-13 |
1336763135 | Jill Elaine Beattie Green | Occupational Therapist | 100 Ky-15, Jackson, KY 41339 | 2020-06-08 |
1023641446 | Andreanna Gibbs | Physical Therapy Assistant | 100 Hwy 15, Jackson, KY 41339 | 2020-02-13 |
1144797754 | Visionary Rehabilitation Services, LLC | Speech-Language Pathologist | 100 Kentucky Hwy 15 South, Suite 136, Jackson, KY 41339 | 2018-11-01 |
1477081206 | Trending Upwards | Counselor | 1754 Highway 15 N, Jackson, KY 41339 | 2017-05-24 |
1508225996 | Jessica Williams | Pharmacist | 842 Highway 15 N, Jackson, KY 41339 | 2016-02-15 |
1245637255 | Breathitt County Ambulance, Inc. | Ambulance | 440 Highway 1812 North, Jackson, KY 41339 | 2014-11-20 |
1265784045 | Jonathan Charles Morris | Physical Therapist | 695 Ky Hwy 15 N, Ste 3, Jackson, KY 41339 | 2012-10-04 |
1649539958 | Henry Price Sewell IIi IIi | Family Medicine | 170 Picnic Hill Rd, Jackson, KY 41339 | 2012-05-07 |
Find all providers in zip 41339 |
Taxonomy Code | 207Y00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Otolaryngology |
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255878062 | W.a. Foote Memorial Hospital, Inc | Otolaryngology | 205 N.east Ave, Jackson, MI 49201 | 2017-01-31 |
1194973941 | Howard B Cheek | Otolaryngology | 4080 Boxwood Circle, Jackson, MS 39211-6609 | 2008-09-05 |
1881712057 | Ear Nose & Throat Surgical Group | Otolaryngology | 764 Lakeland Drive, Suite 200, Jackson, MS 39216-4617 | 2007-03-27 |
1811076938 | Kyle Ford Gordon | Otolaryngology | 970 Lakeland Dr Ste 40, Jackson, MS 39216-4640 | 2006-11-02 |
1285713305 | Andrew Byron Brown IIi | Otolaryngology | 764 Lakeland Dr Ste 200, Jackson, MS 39216-4617 | 2006-11-02 |
1780771956 | Tammy Sanders | Otolaryngology | 1500 E. Woodrow Wilson Ave., Jackson, MS 39216-5199 | 2006-10-06 |
1922097492 | Stephen L Kirkner | Otolaryngology | 1111 Teneyck St, Suite 100, Jackson, MI 49201-2461 | 2005-10-18 |
1720070535 | West Tennessee Ent Clinic, P.a. | Otolaryngology | 619 Skyline Dr, Jackson, TN 38301-3903 | 2005-08-17 |
1245795400 | Dr. Patricia A Murphy Pllc | Otolaryngology | 221 Highway 15 S, Jackson, KY 41339-9600 | 2019-02-01 |
1336677624 | Wendy Nicole Marino | Otolaryngology | 764 Lakeland Dr, Jackson, MS 39216-4651 | 2017-05-31 |
Find all providers in JACKSON |
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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.