Individual
DR. JAMES JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4345 NELSON RD STE 101, LAKE CHARLES, LA 70605-4183
(337) 480-7942
(337) 480-7964
Mailing address
PO BOX 122165 DEPT 2165, DALLAS, TX 75312-0001
(337) 494-2921
(337) 494-6523
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
327406
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2571281
—
LA
01
—
327406
STATE LICENSE
LA
Enumeration date
05/26/2015
Last updated
04/27/2022
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