NPI 1093479297
Marcko Jackson
Practice location
- Address
- 110 Elenore St, Lafayette, LA 70501-4236
- Phone
- (337) 258-1813
Registered specialties
Non-emergency Medical Transport (VAN)
Primary
Registry record
- NPI
- 1093479297
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 25 Oct 2021
- Record last updated
- 25 Oct 2021
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.