NPI 1053914754

Lavar Jackson

Practitioner Transportation Broker Madison, MS

Practice location

Address: 820 Annandale Rd, Madison, MS 39110-7827
Phone: (504) 250-1316

Registered specialties

Transportation Broker Primary

Transportation Services Taxonomy 347E00000X

Other Transportation Broker providers in Mississippi →

Registry record

NPI: 1053914754
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 Nov 2020
Record last updated: 17 Nov 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.