Individual
THOMAS ISAAC JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8166 MAIN ST, HOUMA, LA 70360-3404
(985) 873-4150
Mailing address
314 HAWTHORNE DR, HOUMA, LA 70360-6066
(985) 223-1986
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
024260
IL
Other
Enumeration date
07/21/2006
Last updated
07/08/2007
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