Individual
WYKENA JATAWN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1304 CLIFTON RD NE, DEPARTMENT OF ANESTHESIOLOGY ROOM B 355, ATLANTA, GA 30322-1059
(404) 778-3900
Mailing address
1304 CLIFTON RD NE, DEPARTMENT OF ANESTHESIOLOGY ROOM B 355, ATLANTA, GA 30322-1059
(404) 778-3900
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
002191
GA
Other
Enumeration date
01/08/2008
Last updated
01/08/2008
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