TIMOTHY JAMES JACKSON

LAFAYETTE, LA
NPI1144217969
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: LA  RN 073450)
Enumeration Date2005-10-06
Last Update Date2007-07-08
Business Address
-- TIMOTHY JAMES JACKSON NP
155 HOSPITAL DR
LAFAYETTE, LA 70503-2852
Phone number: 337-269-9777
Mailing Address
-- TIMOTHY JAMES JACKSON NP
PO BOX 52507
LAFAYETTE, LA 70505-2507
Phone number: 337-269-9777
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