Organization
TACKETT MEDICAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN KENTON TACKETT MD (CEO)
(501) 676-1410
Entity
Organization
Contact information
Practice address
5640 MARBLEHEAD DR, COLFAX, NC 27235-9801
(501) 676-1410
Mailing address
5640 MARBLEHEAD DR, COLFAX, NC 27235-9801
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
01/17/2025
Last updated
01/17/2025
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