Individual
DR. JOHN KEVIN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
VA NEW ORLEANS DEPARTMENT OF MENTAL HEALTH, 2400 CANAL STREET, NEW ORLEANS, LA 70119
(504) 507-3380
Mailing address
6312 PERLITA DR, NEW ORLEANS, LA 70122-2242
(504) 352-0232
Taxonomy
Speciality
Code
Description
License number
State
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
020998
LA
2084N0400X
Neurology Physician
Primary
020998
LA
2084P0800X
Psychiatry Physician
020998
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1684201
—
LA
Enumeration date
04/26/2006
Last updated
11/16/2021
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