Farris Jackson is a Specialist in St Louis, Missouri. Farris Jackson practices all healthcare services and medical treatments related to Specialist. The NPI Number for Farris Jackson is 1083618904. The last update date is 2017-02-10.
Farris Jackson's current location address is 11200 Tesson Ferry Rd., St Louis, Missouri. You can contact this provider via phone number 3148491500 and fax number 3148498789. The mailing address for Farris Jackson is 11200 Tesson Ferry Rd., St Louis, Missouri. To know further, please read the information below!
Provider Profile Detail
Provider Name | Farris Jackson |
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Address | 11200 Tesson Ferry Rd., St Louis, Missouri |
Phone Number | 3148491500 |
Fax Number | 3148498789 |
Sole Proprietor | Y |
Credentials | MD |
NPI Number Detail
NPI Number | 1083618904 |
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Provider Enumeration Date | 2005-06-09 |
Last Updated Date | 2017-02-10 |
Provider Mailing Address Detail
Address | 11200 Tesson Ferry Rd. |
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City | St Louis |
State | Missouri (MO) |
Post Code | 6312369220 |
Phone Number | 3148491500 |
Fax Number | 3148498789 |
Provider's Primary Taxonomy Detail
Speciality | Specialist |
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Taxonomy | 174400000X |
Licence No | R9F09 |
Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
290013015 | MO | MEDICARE RAILROAD | |
202531513 | MO | -- |
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What is the unique 10-digit identification code issued to Farris Jackson by the Centers for Medicare & Medicaid Services?
The Farris Jackson has been assigned the NPI (National Provider Identifier) 1083618904 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Can you provide the Farris Jackson's physical address?
The Farris Jackson is physically located at 11200 Tesson Ferry Rd., in the city of St Louis, MO, with the postal code 6312369220.
What is the area of specialization for Farris Jackson, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Farris Jackson is Specialist, and the corresponding taxonomy code that categorizes this area of expertise is 174400000X.
When did the Farris Jackson receive its 1083618904?
The Farris Jackson was issued its 1083618904 on 2005-06-09, which is the date when the organization was assigned this unique identifier.
As of what date were the Farris Jackson's details last updated?
The information pertaining to the Farris Jackson, including its address, specialty, and other details, was most recently updated on 2017-02-10.
NPI Number: 1376546309
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