Provider Demographics
NPI:1235772708
Name:PAXTON, JAMIE (LAC MAC DIPLOM)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:PAXTON
Suffix:
Gender:F
Credentials:LAC MAC DIPLOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 E JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-5328
Mailing Address - Country:US
Mailing Address - Phone:434-260-0603
Mailing Address - Fax:
Practice Address - Street 1:1008 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-5328
Practice Address - Country:US
Practice Address - Phone:434-260-0603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-28
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist