Individual
MR. THOMAS EDWARD JAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
Mailing address
1541 KINGS HWY, ATTN: PAYOR CREDENTIALING, SHREVEPORT, LA 71103-4228
(318) 626-0287
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
211298
LA
367500000X
Certified Registered Nurse Anesthetist
Primary
211298
LA
Other
Enumeration date
07/25/2024
Last updated
03/12/2026
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