Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LASALLE JACKSON
ActiveLASALLE JACKSON is a Driver healthcare provider located in PORT GIBSON, Mississippi. NPI 1508331711 is currently active in the NPPES registry. Verify at CMS.
Driver · PORT GIBSON, MS
Registration Details
- NPI Number
- 1508331711
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 4, 2018 (7.833309282518 yrs)
- Last Updated
- Oct 4, 2018
Practice Information
- Address
-
606 WALNUT STPORT GIBSON, MS, 391502140Browse MS providers · Browse ZIP 39150
- Phone
- 6015290527
- Primary Specialty
-
Driver
172A00000X
Other Driver Providers in PORT GIBSON, MS
| Name | Credential | NPI |
|---|---|---|
| MS. GERALINE SMITH | — | 1215729033 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.