Individual
DR. LAFARRA DEMETRIC YOUNG-GAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1530
Mailing address
442 ASHTREE LN, MADISON, MS 39110-6703
(601) 405-4163
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
20180
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07189228
—
MS
05
—
156938
—
AL
Enumeration date
09/07/2008
Last updated
03/17/2014
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