Jacks Dermatology P.A.
NPI 1558621367ActiveOrganization· Dermatology· Pine Bluff, AR
Dermatology in Pine Bluff, Arkansas, registered in NPPES in May 2012. The authorized official on file is Jennifer L. Jacks, M.D., President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1558621367 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 26, 2012 |
| Last updated in NPPES | May 26, 2012 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | E7442 | AR |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AR) |
|---|
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