Individual
DANNY J. JACKSON SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.D.
Contact information
Practice address
5352 HOSPITAL BLVD, PINEVILLE, LA 71360
(318) 473-6257
(318) 767-5330
Mailing address
6437 TWIN BRIDGES RD, ALEXANDRIA, LA 71303-7714
(318) 445-5579
(318) 767-5330
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14055
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14055
PHARMACY LICENSE NUMBER
LA
Enumeration date
02/21/2007
Last updated
07/08/2007
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