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Individual
DR. JACOB RANDALL LASSITER
Active
Individual
DR. JACOB RANDALL LASSITER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
24652
MS
207V00000X
Obstetrics & Gynecology Physician
Primary
ME140756
FL
390200000X
Student in an Organized Health Care Education/Training Program
MD.34009
AL
Other
Enumeration date
04/17/2013
Last updated
11/10/2021
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