Organization
LOVE KIDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YVONNE JACKSON M.D. (CEO)
(301) 262-4784
Entity
Organization
Contact information
Practice address
14300 GALLANT FOX LN, 203, BOWIE, MD 20715-4003
(301) 262-4784
(301) 262-2767
Mailing address
14300 GALLANT FOX LN, 203, BOWIE, MD 20715-4003
(301) 262-4784
(301) 262-2767
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D0050706
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1580001P0000
—
MD
Enumeration date
03/07/2016
Last updated
03/07/2016
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