Provider Demographics
NPI:1154588986
Name:REESE, JACALYN HOWZE (MD)
Entity type:Individual
Prefix:DR
First Name:JACALYN
Middle Name:HOWZE
Last Name:REESE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JACALYN
Other - Middle Name:HOWZE
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PSC 819 BOX 4474
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09645-0045
Mailing Address - Country:US
Mailing Address - Phone:251-648-7507
Mailing Address - Fax:
Practice Address - Street 1:PSC 810 BOX 35
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09589
Practice Address - Country:US
Practice Address - Phone:251-648-7507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL30268207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology