Individual
MICHAEL M JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2900 WESTFORK DR STE 401, BATON ROUGE, LA 70827-0004
(504) 914-2065
Mailing address
4919 FAIRFIELDS AVE, BATON ROUGE, LA 70802-1012
Taxonomy
Speciality
Code
Description
License number
State
342000000X
Transportation Network Company
Primary
—
—
Other
Enumeration date
10/01/2024
Last updated
10/01/2024
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