MEDICARE: TINA SCOTT-JACKSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	PLMS	AR

General Provider Information

NPI Number	:	1760333462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TINA SCOTT-JACKSON

Provider Business Mailing Address
First Line	:	607 N 1ST ST STE 1
Second Line	:
City	:	JACKSONVILLE
State	:	AR
Zip	:	72076-4142
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	607 N 1ST ST STE 1
Second Line	:
City	:	JACKSONVILLE
State	:	AR
Zip	:	72076-4142
Country	:	US
Telephone Number	:	501-256-5898
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2026
Last Update Date	:	02/07/2026

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Directions to “ TINA SCOTT-JACKSON ” Practice Location

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