Search › Mississippi › 363L00000X
Dominique Jackson
NPI 1679000814 · on the registry since 2017
Practice
- Address
- 766b Lakeland Dr
Jackson, MS 39216 - Phone
- (601) 982-2916
- Fax
- (601) 366-2916
Registry record
- Primary taxonomy
- 363L00000X
363L00000X
- Licence states on file
- MS
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2021-04-20
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Mississippi