Search › Louisiana › 101YM0800X
Charles Jackson
NPI 1457896839 · on the registry since 2016
Practice
- Address
- 2911 Penick St
Shreveport, LA 71109 - Phone
- (318) 393-8396
Registry record
- Primary taxonomy
- 101YM0800X
101YM0800X
- Licence states on file
- LA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2016-12-21
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