Wallace J Jackmon in Sioux Falls - Clinical
Wallace J Jackmon - NPI 1427020957
Wallace J Jackmon is a Clinical in Sioux Falls, South Dakota. Wallace J Jackmon practices all healthcare services and medical treatments related to Clinical. The NPI Number for Wallace J Jackmon is 1427020957. The last update date is 2018-10-11.
Wallace J Jackmon's current location address is Po Box 86370, Sioux Falls, South Dakota. You can contact this provider via phone number 6053227510 and fax number 6053226475. The mailing address for Wallace J Jackmon is Po Box 86370, Sioux Falls, South Dakota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Wallace J Jackmon |
|---|---|
| Address | Po Box 86370, Sioux Falls, South Dakota |
| Phone Number | 6053227510 |
| Fax Number | 6053226475 |
| Sole Proprietor | N |
| Credentials | PHD |
NPI Number Detail
| NPI Number | 1427020957 |
|---|---|
| Provider Enumeration Date | 2006-02-07 |
| Last Updated Date | 2018-10-11 |
Provider Mailing Address Detail
| Address | Po Box 86370 |
|---|---|
| City | Sioux Falls |
| State | South Dakota (SD) |
| Post Code | 571186370 |
| Phone Number | 6053227510 |
| Fax Number | 6053226475 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 477 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 12200 | ND | -- | |
| 46022474352 | NE | -- | |
| 854000 | SD | ARAZ/ AMERICA'S PPO | |
| 944611700 | MN | -- | |
| 40537 | SD | BLUE CROSS | |
| 140M8JA | MN | CC SYSTEMS/ BLUE PLUS | |
| 142415 | MN | UCARE | |
| 412991020844 | SD | PREFERRED ONE | |
| 6552790 | SD | -- | |
| 6570753 | SD | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Wallace J Jackmon by the Centers for Medicare & Medicaid Services (CMS)?
The Wallace J Jackmon has been assigned the NPI (National Provider Identifier) 1427020957. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you provide the complete physical address where Wallace J Jackmon is located?
The Wallace J Jackmon is situated at the following address: Po Box 86370, Sioux Falls, SD, 571186370.
What is the Wallace J Jackmon's specialty and taxonomy code?
The Wallace J Jackmon's specialty is Clinical, and the corresponding taxonomy code is 103Tc0700X.
On what date did Wallace J Jackmon receive its 1427020957 assignment from the Centers for Medicare & Medicaid Services?
The Wallace J Jackmon was assigned its 1427020957 on 2006-02-07, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Wallace J Jackmon most recently updated?
The details pertaining to the Wallace J Jackmon, including its address, specialty, and other relevant information, were last refreshed on 2018-10-11.
NPI Number: 1528061710
Address: 19 Nh Route 104, Meredith, NH