Charles David Jackson
MD | Pediatrics | Male
Charles David Jackson, MD is a Fayetteville, Arkansas based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Charles David Jackson is
3380 N Futrall Dr Ste 1, Fayetteville, Arkansas - 72703. He can be contacted on phone at
479-442-7322 and fax number 479-442-7379.
Charles David Jackson is a sole proprietor of his business.
NPI number (Unique professional ID) for Charles David Jackson is
1508800665 which was assigned by NPPES on 16 Jun, 2006 and it was last updated on 29 Dec, 2021.
Charles David Jackson license number is
C-6427 for Pediatrics (208000000X) in Arkansas.
Charles David Jackson is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Charles David Jackson basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
|---|
| Provider Name : | Charles David Jackson |
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| Credential : | MD |
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| Gender : | Male |
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Business Address:
Charles David Jackson address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 3380 N Futrall Dr Ste 1
Fayetteville, AR, 72703
United States |
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| Phone Number : | 479-442-7322 |
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| Fax Number : | 479-442-7379 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1508800665 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 16 Jun, 2006 |
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| Last Updated On : | 29 Dec, 2021 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Charles David Jackson are as mentioned. Primary taxonomy code for Charles David Jackson, MD is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | C-6427 | AR |
Legacy Identifiers:
Other legacy medical identifiers of Charles David Jackson such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 113041001 | MEDICAID | AR | |
| 51110 | Other | AR | AR BC/BS |
Endpoints:
Endpoints provide a simple, secure, scalable, and standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet. It is used by EHR systems (Electronic Health Records).
| Endpoint Type | Endpoint | Affiliation | Use | Content | Address |
|---|
DIRECT
(Direct Messaging Address) | charles.jackson@mana.eclinicaldirectplus.com
charles.jackson@mana.eclinicaldirectplus.com | No affiliation | DIRECT
Direct
| OTHER
Other
CCDA | 3380 N FUTRALL DR STE 1,
FAYETTEVILLE, AR, 72703
United States |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | Po Box 1523
Fayetteville, AR, 72702-1523
United States |
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| Phone Number : | 479-571-6038 |
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| Fax Number : | 479-582-0222 |
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Business Location:
Patients can refer following map for directions to
Charles David Jackson practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.