TACKETT MEDICAL PLLC NPI 1245041243

NPI Information

  • NPI: 1245041243
  • Provider Name: TACKETT MEDICAL, PLLC
  • Classification: Family Medicine - 207QG0300X
  • Specialization: Geriatric Medicine
  • Entity Type: Organization
  • Address: 5640 MARBLEHEAD DR
    COLFAX, NC
    ZIP 27235
  • Phone: (501) 676-1410

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NPI Details

TACKETT MEDICAL, PLLC is a geriatric medicine family medicine in Colfax, NC. The provider is a family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. TACKETT MEDICAL, PLLC NPI is 1245041243. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5640 MARBLEHEAD DR
COLFAX, NC
ZIP 27235-801
Phone: (501) 676-1410

The provider's authorized official is Jonathan Kenton Tackett .
The authorized official title is Ceo and has the following contact phone number (501) 676-1410.

The enumeration date for this NPI number is 1/17/2025 and was last updated on 1/17/2025.

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
1207QG0300XFamily MedicineGeriatric MedicineYes

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: 11/21/2025

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