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Contact Information

LATOYA JACKSON
5742 JODPHUR CT
TALLAHASSEE, FL32303-6748
 Phone: 850-728-3413
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Point of Service

305S00000X
 

Health Maintenance Organization

302R00000X
 

Independent Duty Corpsman

1710I1002X
Indicates primary specialty

NPI Profile & details for LATOYA JACKSON · (Female)

NPI Number 1659807477
Status Active
Credentials
Entity Individual
Enumeration date 05/11/2017
Last updated 05/11/2017 - About 9 years ago
Sole proprietor 1 Yes
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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