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Organization
INTEGRATED MEDICAL STAFF OF JACKSON PC
Active
Organization
INTEGRATED MEDICAL STAFF OF JACKSON PC
Active
Parent organization
JACKSON CLINIC, PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
JACKSON CLINIC, PA
Authorized official
MR. MARK ALLEN (CEO)
(731) 422-0330
Entity
Organization
Contact information
Practice address
828 N PARKWAY, JACKSON, TN 38305-3032
(731) 422-0330
(731) 422-0499
Mailing address
828 N PARKWAY, JACKSON, TN 38305-3032
(731) 422-0330
(731) 422-0499
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
NULL
207L00000X
Anesthesiology Physician
—
—
207N00000X
Dermatology Physician
—
NULL
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
NULL
207RC0000X
Cardiovascular Disease Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
NULL
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0100X
Gastroenterology Physician
—
NULL
207RG0100X
Gastroenterology Physician
—
—
207RH0000X
Hematology (Internal Medicine) Physician
—
NULL
207RH0000X
Hematology (Internal Medicine) Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
NULL
207RI0011X
Interventional Cardiology Physician
—
—
207RI0200X
Infectious Disease Physician
—
NULL
207RI0200X
Infectious Disease Physician
—
—
207RN0300X
Nephrology Physician
—
NULL
207RN0300X
Nephrology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
NULL
207RP1001X
Pulmonary Disease Physician
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
NULL
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
208M00000X
Hospitalist Physician
—
NULL
208M00000X
Hospitalist Physician
—
—
Other
Enumeration date
12/11/2014
Last updated
12/11/2014
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