Individual
DR. BYRON ANDRA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
653 W 70TH ST, SHREVEPORT, LA 71106-2949
(318) 636-8389
(318) 636-8389
Mailing address
PO BOX 740012, ATLANTA, GA 30374-0012
(773) 352-1515
(312) 929-0373
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
08028R
LA
Other
Enumeration date
11/07/2006
Last updated
05/14/2024
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