Individual
DR. WALTER CHARLES JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
4051 VETERANS MEMORIAL BLVD, SUITE 200, METAIRIE, LA 70002-5572
(504) 455-7161
(504) 455-7162
Mailing address
4051 VETERANS MEMORIAL BLVD STE 200, METAIRIE, LA 70002-5567
(504) 455-7161
(504) 455-7162
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5927
LA
Other
Enumeration date
05/06/2008
Last updated
06/17/2009
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