NPI Code Detail JSON Logo

1699948901 NPI number — JENNIFER LYNN JACKS M.D.

NPI Number: 1699948901
Health Care Provider/Practitioner: JENNIFER LYNN JACKS M.D.

Information about “1699948901” NPI (JENNIFER LYNN JACKS M.D.) exists in 1699948901 in HTML format HTML  |  1699948901 in plain Text format TXT  |  1699948901 in PDF (Portable Document Format) PDF  |  1699948901 in an XML format XML  formats.

NPI Number : 1699948901 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1699948901",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "JACKS",
    "FirstName": "JENNIFER",
    "MiddleName": "LYNN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1710 W 42ND AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PINE BLUFF",
    "MailingAddressStateName": "AR",
    "MailingAddressPostalCode": "71603",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "870-534-7546",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1718 W 42ND AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PINE BLUFF",
    "PracticeLocationAddressStateName": "AR",
    "PracticeLocationAddressPostalCode": "71603-7008",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "870-534-7546",
    "PracticeLocationAddressFaxNumber": "870-534-2343",
    "EnumerationDate": "04/08/2008",
    "LastUpdateDate": "09/29/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207N00000X",
        "TaxonomyName": "Dermatology Physician",
        "LicenseNumber": "E7442",
        "LicenseNumberStateCode": "AR",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.