Individual
DR. LANA LIANE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, DEPT OF OTOLARYNGOLOGY, JACKSON, MS 39216-4500
(601) 815-3781
(601) 984-5085
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-3781
(601) 984-5085
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
056101
GA
207Y00000X
Otolaryngology Physician
Primary
22626
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08350002
—
MS
05
—
170144
—
AL
Enumeration date
05/03/2007
Last updated
03/01/2016
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