Tackett Medical, PLLC
Organization Active NPI Geriatric Medicine (Family Medicine) Physician · Colfax, NC
NPI 1245041243 · NPPES record last updated Jan 17, 2025
Key facts
- NPI
- 1245041243
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Geriatric Medicine (Family Medicine) Physician 207QG0300X
- Legal business name
- TACKETT MEDICAL, PLLC
- Practice address
- 5640 Marblehead Dr
Colfax, NC 27235-9801 - Phone
- (501) 676-1410
- NPI assigned
- Jan 17, 2025
- Organization subpart
- No
Authorized official
- Name
- Jonathan Kenton Tackett, MD
- Title
- Ceo
- Phone
- (501) 676-1410
Practitioners 1
-
Jonathan Kenton Tackett, M.D.
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician |
207QG0300X | Yes |
Addresses
Primary practice location
5640 Marblehead Dr
Colfax, NC 27235-9801
Mailing address
5640 Marblehead Dr
Colfax, NC 27235-9801
Other providers in Colfax, NC
- Indira J Reddy
- Sarah Rivera Lopez
- Luis Alberto Sanchez
- Heather R. Smith
- Hannah Spach
- Timothy Barber, DMD, P.a.
- Gina M Tucker
- Jessica D Whitehead
All providers in Colfax, NC · Geriatric Medicine (Family Medicine) Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.