Individual
DR. LATOYA DANIELLE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
233 N HOUSTON RD, SUITE 140 E, WARNER ROBINS, GA 31093-3074
(478) 975-6880
(478) 975-6869
Mailing address
233 N HOUSTON RD, SUITE 140 E, WARNER ROBINS, GA 31093-3074
(478) 975-6880
(478) 975-6869
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
061972
GA
Other
Enumeration date
04/18/2007
Last updated
06/11/2012
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