Doctor Name: | BRADLEY JACKSON |
NPI Number: | 1467738195 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MHPP |
License Number: | |
Business Practice Address: | 634 W Main St Blytheville, AR - 723153336 |
Business Phone Number: | 8707806986 |
Business Fax Number: | 8708706987 |
Mailing Address: | 634 W Main St, BLYTHEVILLE |
State: | AR |
Postal Code: | 723153336 |
Phone Number: | 8707806986 |
Fax Number: | 8708706987 |
NPI Enumeration Date: | 10/26/2011 |
NPI Last Update Date: | 10/26/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171M00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Case Manager/Care Coordinator |
Taxonomy Specialization: | |
Taxonomy Definition: | A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee |