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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

KENNETH JACKSON

Active Organization

KENNETH JACKSON is a Van Provider organization located in LAKE CHARLES, Louisiana. NPI 1659743029 is currently active in the NPPES registry. Verify at CMS.

Van Provider · LAKE CHARLES, LA

Registration Details

NPI Number
1659743029
Provider Type
Organization
NPI Issued
Oct 26, 2015 (10.796877827405 yrs)
Last Updated
Oct 26, 2015
License
008046248 (LA)

Practice Information

Address
1216 OKLAHOMA ST
LAKE CHARLES, LA, 706073624
Browse LA providers · Browse ZIP 70607
Phone
3374198236
Primary Specialty
Van Provider
344600000X

Other Van Provider Organizations in LAKE CHARLES, LA

Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.