Organization
JACKSON STREET MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE G ZAVALETA MD (PHYSICIAN)
(318) 445-0129
Entity
Organization
Contact information
Practice address
5623 JACKSON STREET EXT, ALEXANDRIA, LA 71303-2326
(318) 455-0129
(318) 443-3284
Mailing address
5623 JACKSON STREET EXT, ALEXANDRIA, LA 71303-2326
(318) 455-0129
(318) 443-3284
Taxonomy
Speciality
Code
Description
License number
State
261QF0050X
Non-Surgical Family Planning Clinic/Center
Primary
12742R
LA
Other
Enumeration date
11/23/2007
Last updated
11/23/2007
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