Young-Gaylor, Lafarra Demetric

Young-Gaylor, Lafarra Demetric is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as her primary health care specialty. Young-Gaylor, Lafarra Demetric can be contacted via phone (601) 984-1530.

Contact Information

Primary practice address
2500 N State St Jackson MS 39216-4500
Phone: (601) 984-1530
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 20180 Mississippi

Profile Details

NPI number 1700034451
LBN Legal business name Young-Gaylor, Lafarra Demetric
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 7th, 2008
Last updated Mar 17th, 2014 - about 12 years ago

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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Identifiers

StateTypeNumberIssuer
All States NPI 1700034451 NPPES
Mississippi MEDICAID 07189228
Mississippi MEDICAID 156938

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