Individual
DR. STEVEN MICHAEL JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
601 KEYSER AVE, NATCHITOCHES, LA 71457-6020
(318) 354-2555
(318) 354-0101
Mailing address
PO BOX 2475, NATCHITOCHES, LA 71457-2475
(318) 663-6131
(318) 214-4651
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
DO.322073
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000139622
—
AL
05
—
023297600
—
FL
05
—
178509003
—
AR
Enumeration date
06/10/2008
Last updated
07/15/2020
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