Jackson, Kodi Long

Jackson, Kodi Long is an individual health care provider with primary practice located at 969 Lakeland Dr , Jackson MS 39216-4606. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Jackson, Kodi Long can be contacted via phone (601) 200-3631.

Contact Information

Primary practice address
969 Lakeland Dr Jackson MS 39216-4606
Phone: (601) 200-3631
Fax: (601) 200-0159
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1588373716
LBN Legal business name Jackson, Kodi Long
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2022
Last updated Nov 3rd, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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