Individual
HENRY A JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4224 HOUMA BLVD STE 380, METAIRIE, LA 70006-2980
(504) 454-5213
(504) 456-8053
Mailing address
4224 HOUMA BLVD 380, EJ PULMONARY MEDICINE EJPULM, METAIRIE, LA 70006-2980
(504) 454-5213
(504) 456-8053
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
L010098
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1129054
—
LA
Enumeration date
02/27/2006
Last updated
09/23/2019
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