Search › Louisiana › 172A00000X
Kenneth Jackson
NPI 1902612740 · on the registry since 2024 · sole proprietor
Practice
- Address
- 8630 Antioch Rd
Baton Rouge, LA 70817 - Phone
- (504) 667-8133
Registry record
- Primary taxonomy
- 172A00000X
172A00000X
- Licence states on file
- LA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-12-06
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