Individual
MELVIN JACKSON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PD
Contact information
Practice address
920 W GLORIA SWITCH RD, LAFAYETTE, LA 70507-2310
(337) 896-0128
Mailing address
920 W GLORIA SWITCH RD, LAFAYETTE, LA 70507-2310
(337) 896-0128
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14588
LA
Other
Enumeration date
08/19/2010
Last updated
01/05/2023
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