Physician Compare National (NPI:1407296775)

HEALTHCARE PROVIDER: DARRIN JACKSON M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1407296775
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9931423829
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160909000819
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	JACKSON
	Individual professional last name
Provider First Name	DARRIN
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2013
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1425 FREMAUX AVE
	Group Practice or individual's line 1 address
City	SLIDELL
	Group Practice or individual's city
State	LA
	Group Practice or individual's state
Zip Code	704583150
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	191300
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST HELENA PARISH HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	191303
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ASSUMPTION COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	190036
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	OCHSNER MEDICAL CENTER NEW ORLEANS
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y