Kendrick Jackson
Full Name
Kendrick Jackson
NPI Number
1013391176
NPI Type
Individual Provider
Gender
Male
Enumeration Date
07/17/2015
Specialties
(Taxonomies)Name
Code
101YA0400X
103K00000X
103TC2200X
1041C0700X
101Y00000X
101YM0800X
101YP2500X
103TR0400X
104100000X
Primary Taxonomy
No
No
No
No
No
No
No
No
No
Contact
Information
Purpose
Mailing
Location
Address
311 CHURCH ST
311 CHURCH ST
City
Natchitoches
Natchitoches
State
LA
LA
Postal Code
71457-4612
71457-4612
Country
US
US
Telephone Number
N/A
(318) 451-6011
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 07/17/2015