Organization
JACKSON COUNTY HOSPITAL DISTRICT
Active
Other names
Jackson County Hospital Physicians Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ASA WILSON (ADMINISTRATOR/CEO)
(361) 782-5241
Entity
Organization
Contact information
Practice address
1013 S. WELLS STREET, EDNA, TX 77957-4098
(361) 782-5241
(361) 782-7495
Mailing address
1013 S. WELLS STREET, EDNA, TX 77957-4098
(361) 782-5241
(361) 782-7495
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00U54J
BLUE CROSS
TX
05
—
083697501
—
TX
Enumeration date
06/16/2006
Last updated
10/15/2009
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