Provider Demographics
NPI:1235486341
Name:JACKSON, SCHMEKIA MONIQUE (DC)
Entity Type:Individual
Prefix:DR
First Name:SCHMEKIA
Middle Name:MONIQUE
Last Name:JACKSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3479 CHISWELL RD
Mailing Address - Street 2:APT #204
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-2134
Mailing Address - Country:US
Mailing Address - Phone:504-390-8411
Mailing Address - Fax:
Practice Address - Street 1:4302 SAINT BARNABAS RD
Practice Address - Street 2:SUITE A
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-1842
Practice Address - Country:US
Practice Address - Phone:240-788-6412
Practice Address - Fax:240-788-6435
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCCH030105111N00000X
MDS03708111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor