Provider Demographics
NPI:1003519851
Name:JACKSON, WHITNEY ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:ELIZABETH
Last Name:JACKSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:ELIZABETH
Other - Last Name:GRIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1600 SW ARCHER RD RM 4101
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-3003
Mailing Address - Country:US
Mailing Address - Phone:352-265-0239
Mailing Address - Fax:352-265-1107
Practice Address - Street 1:1600 SW ARCHER RD RM 4101
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-265-0239
Practice Address - Fax:352-265-1107
Is Sole Proprietor?:No
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program