=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235781618
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JODELLE MCFARLAND DC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/15/2019
-----------------------------------------------------
Last Update Date | 11/26/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3687 THOUSAND OAKS DRIVE
-----------------------------------------------------
City | ORANGE PARK
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32065
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 904-466-8081
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9526 ARGYLE FOREST BLVD STE B2 #368
-----------------------------------------------------
City | JACKSONVILLE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32222
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 904-466-8081
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | CH12192
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------