SearchLouisiana101YA0400X

Womble Jackson

NPI 1740802123 · on the registry since 2020 · sole proprietor

Practice

Address
2003 Franklin Ave
Ruston, LA 71270
Phone
(318) 331-3977
Fax
(318) 224-9056
Organisation at this address
Buddy Drivers Llc
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
101YA0400X
101YA0400X
Also registered as
343900000X
Sex
Male
Record last updated
2025-08-26

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