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DR. JACKIE ROSE MD NPI 1073552691


NPI Information

NPI: 1073552691
Provider Name: DR. JACKIE ROSE, MD
Classification: Emergency Medicine - 207P00000X
Entity Type: Individual
Address:
1000 S BECKHAM AVE
TYLER, TX
ZIP 75701
Phone: (903) 597-0351
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DR. Jackie Rose, MD is an emergency medicine in Tyler, TX. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. DR. Jackie Rose, MD NPI is 1073552691. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1000 S BECKHAM AVE
TYLER, TX
ZIP 75701-908
Phone: (903) 597-0351
Fax: (903) 592-5282

The enumeration date for this NPI number is 6/6/2006 and was last updated on 11/2/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207P00000XEmergency MedicineH2738TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
18839B6MEDICARE PINTEXAS
2E20041MEDICARE UPINTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.