Individual
DR. JON RICHARD JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5000 HENNESSY BLVD, BATON ROUGE, LA 70808-4375
(225) 765-4050
(225) 765-4046
Mailing address
5000 HENNESSY BLVD, BATON ROUGE, LA 70808-4375
(225) 765-4050
(225) 765-4046
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
12488R
LA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
12488R
LA
207RP1001X
Pulmonary Disease Physician
12488R
LA
208M00000X
Hospitalist Physician
12488R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01738210
—
MS
05
—
1535931
—
LA
01
—
P00020219
RAIL ROAD MEDICARE
—
Enumeration date
08/16/2005
Last updated
03/26/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us