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Jack Fenner
NPI 1205629672 · on the registry since 2025 · sole proprietor
Practice
- Address
- 427 Prestonwood Dr
Shreveport, LA 71115 - Phone
- (318) 344-3686
Registry record
- Primary taxonomy
- 2255A2300X
2255A2300X
- Licence states on file
- LA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-05-27
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Louisiana