Provider Demographics
NPI:1306438437
Name:PAUL-JACKSON, JAMILA A
Entity type:Individual
Prefix:DR
First Name:JAMILA
Middle Name:A
Last Name:PAUL-JACKSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5784 LUMBERJACK LN
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-6747
Mailing Address - Country:US
Mailing Address - Phone:850-508-6565
Mailing Address - Fax:
Practice Address - Street 1:5784 LUMBERJACK LN
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-6747
Practice Address - Country:US
Practice Address - Phone:850-508-6565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor