Individual
FARRIS JACKSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11200 TESSON FERRY RD., STE 100, ST LOUIS, MO 63123-6922
(314) 849-1500
(314) 849-8789
Mailing address
11200 TESSON FERRY RD., STE 100, ST LOUIS, MO 63123-6922
(314) 849-1500
(314) 849-8789
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R9F09
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202531513
—
MO
01
—
290013015
MEDICARE RAILROAD
MO
Enumeration date
06/09/2005
Last updated
02/10/2017
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us