Provider Demographics
NPI:1154381598
Name:JAKES, MARGARET EARLEY (MD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:EARLEY
Last Name:JAKES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1420 NARROW LANE PKWY
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36111-2654
Mailing Address - Country:US
Mailing Address - Phone:334-284-4196
Mailing Address - Fax:334-284-4256
Practice Address - Street 1:1420 NARROW LANE PKWY
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36111-2654
Practice Address - Country:US
Practice Address - Phone:334-284-4196
Practice Address - Fax:334-284-4256
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL10169207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALD08142Medicare UPIN