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1952306672

NPI Code Detail

MEDICARE: MOTHER FRANCES HOSPITAL JACKSONVILLE

MEDICARE: MOTHER FRANCES HOSPITAL JACKSONVILLE

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	367500000X	Certified Registered Nurse Anesthetist
2	282NC0060X	Critical Access Hospital	007254	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	HH0993	OTHER	TX	BLUE CROSS

General Provider Information

NPI Number	:	1952306672
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOTHER FRANCES HOSPITAL JACKSONVILLE

Provider Business Mailing Address
First Line	:	PO BOX 847522
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-7522
Country	:	US
Telephone Number	:	903-541-4500
Fax Number	:	903-541-4679

Provider Business Practice Location Address
First Line	:	2026 S JACKSON ST
Second Line	:
City	:	JACKSONVILLE
State	:	TX
Zip	:	75766-5822
Country	:	US
Telephone Number	:	903-541-4500
Fax Number	:	903-541-4679

Authorized Official
Title or Position	:	PROVIDER ENROLLMENT SPECIALIST
Name	:	ANGELA HUFF
Credential	:
Telephone Number	:	903-606-6425

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	01/12/2022

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Directions to “MOTHER FRANCES HOSPITAL JACKSONVILLE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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