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1952409567
PATRICIA JACKSON MD, LLC
MARRERO, LA
NPI
1952409567
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Entity Type
Organization
Authorized Contact
JAMES O THEIS
Authorized Official
504-349-2908
Organization Subpart ?
No
Primary Taxonomy
207R00000X Internal Medicine
Enumeration Date
2006-09-20
Last Update Date
2018-08-21
Business Address
PATRICIA JACKSON MD, LLC
1111 MEDICAL CENTER BLVD SUITE N408
MARRERO, LA 70072
Phone number: 504-349-2908
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Mailing Address
PATRICIA JACKSON MD, LLC
6019 CONSTANCE ST
NEW ORLEANS, LA 70118-5806
Phone number: 504-349-2908
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