Organization
PEACE OUTPOST
Active
Other names
PEACE OUTPOST
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYLE JACKSON (MEDICAL OFFICER)
(720) 335-5339
Entity
Organization
Contact information
Practice address
1423 E WILLOW ST APT 5, LAFAYETTE, LA 70501-3834
(337) 254-0675
Mailing address
628 N 4TH ST, BATON ROUGE, LA 70802-5342
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
07/26/2025
Last updated
07/26/2025
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