Individual
PAUL M JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
MD.025993
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09306510
—
MS
05
—
1050032
—
LA
Enumeration date
06/27/2007
Last updated
04/29/2021
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