Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 10169 | AL |
NPI | 1154381598 |
---|---|
Provider Name | Dr. Margaret Earley Jakes |
First Address | Montgomery, AL 36111-2654 |
Second Address | Montgomery, AL 36111-2654 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2006 |
Last Update Date | 17/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D08142 | (02) | AL |