Kimyuana Jackson
Family Doctor - Adult Medicine
20 Hobo Fork Rd
Natchez
, Mississippi 39120-9025
Kimyuana Jackson
Family Doctor - Adult Medicine
20 Hobo Fork Rd
Natchez
, Mississippi 39120-9025
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About
Features
Specialties
- Family Doctor - Adult Medicine
Languages spoken
- English
Location
First Address
- Kimyuana Jackson
- 20 Hobo Fork Rd
- Natchez, MS
- Zip : 39120-9025
- Phone :
Second Address
- Kimyuana Jackson
- 20 Hobo Fork Rd
- Natchez, MS
- Zip : 39120-9025
- Phone : (601) 304-2558
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QA0505X | Family Doctor - Adult Medicine | 904207 | MS |
National Provider Identifier
| NPI | 1184222374 |
|---|---|
| Provider Name | Kimyuana Jackson |
| First Address | Natchez, MS 39120-9025 |
| Second Address | Natchez, MS 39120-9025 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/10/2020 |
| Last Update Date | 11/10/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.