NPI 1063357473

Lauran Dekease Jackson

Practitioner Medical Toxicology (Preventive Medicine) Physician Petersburg, VA

Practice location

Address: 10543 South Crater Road, Petersburg, VA 23805
Phone: (804) 481-5259

Registered specialties

Medical Toxicology (Preventive Medicine) Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2083T0002X Licence 1401115318 (VA)

Other Preventive Medicine providers in Virginia →

Registry record

NPI: 1063357473
Entity type: Individual
Sex (as registered): Female
NPI issued: 22 Apr 2026
Record last updated: 22 Apr 2026

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.