JOHN G JACKSON (NPI# 1063497683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063497683 |
| Entity Type | Individual |
| Full Name | JOHN G JACKSON |
| Credential | M.D. |
| Practice Address |
13030 Highway 308 Larose LA 70373-2001 |
| Practice Telephone | 9857987000 |
| Practice Fax Number | 9857987021 |
| Mailing Telephone | 9857987000 |
| Mailing Fax Number | 9857987021 |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2019-06-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD019331 | LA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | MD15556 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1030589 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801439799 | John Archie Jackson Jr. | Counselor | 209 Martin Luther King Dr, Elizabethtown, NC 28337 | 2019-10-23 |
| 1063073310 | John Jackson | Speech-Language Pathologist | 2143 Mohawk Trl, Maitland, FL 32751-3950 | 2019-06-27 |
| 1992202832 | John Jackson | Physical Therapy Assistant | 209 Lake St, Chittenango, NY 13037-1518 | 2018-04-08 |
| 1063911105 | John Martin Jackson | Physical Therapy Assistant | 11118 Lantern Way, North Chesterfield, VA 23236-3575 | 2018-02-05 |
| 1184164493 | John Jackson | Emergency Medical Technician, Paramedic | 137 S Newport Ave, Newport, WA 99156-1942 | 2017-03-06 |
| 1508236837 | John Willard Jackson | Anesthesiology | 7857 Caruth Ct, Dallas, TX 75225-8133 | 2015-09-29 |
| 1043572035 | John Ferndale Jackson | Behavioral Analyst | 931 Azure Heights Place, Las Vegas, NV 89110 | 2012-06-14 |
| 1679830558 | John Michael Jackson | Pharmacist | 1000 Castlebay, Cincinnati, OH 45245-4910 | 2012-04-18 |
| 1013043553 | John Phillip Jackson | Occupational Therapist | 7810 Avenue U Apt B, Lubbock, TX 79423-2430 | 2007-02-26 |
| 1275673451 | John W Jackson | Pharmacist | 1667 Bellemeade Dr, Altoona, PA 16602-7402 | 2007-02-07 |
| Street Address |
13030 HIGHWAY 308 |
| City | LAROSE |
| State | LA |
| Zip Code | 70373-2001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073977054 | Amanda Olivier Rogers | Family Medicine | 13030 Highway 308, Larose, LA 70373-2001 | 2016-04-06 |
| 1124256706 | Melissa G Marcombe | Nurse Practitioner | 13030 Highway 308, Larose, LA 70373-2001 | 2009-06-23 |
| 1740485754 | Jay Vega Md.,a.p.m.c. | Clinic/Center | 13030 Highway 308, Larose, LA 70373 | 2007-06-19 |
| 1508913195 | Christine Dessauer Mcdaniel | Physician Assistant | 13030 Highway 308, Larose, LA 70373-2056 | 2007-01-04 |
| 1932256542 | Lafourche Parish Hospital Service District No.1 | Family Medicine | 13030 Highway 308, Larose, LA 70345-4143 | 2007-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063968295 | Sabrina Hagar | Pharmacist | 13998 W Main Street, Larose, LA 70373 | 2016-08-28 |
| 1801028154 | Travis Paul Toups | Physical Therapist | 13554 Highway 3235, Ste B, Larose, LA 70373 | 2009-08-20 |
| 1518180322 | Christine Miller Cedotal | Physical Therapist | 11109 Hwy. 308, Larose, LA 70373 | 2007-04-10 |
| 1619455037 | Sleep Better Louisiana, LLC | Dentist | 13373 Highway 3235, Larose, LA 70373 | 2018-07-30 |
| 1619494234 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 13998 W Main St, Larose, LA 70373 | 2017-08-24 |
| 1003175795 | Trang Tran | Pharmacist | 13998 W Main St, Larose, LA 70373 | 2012-05-15 |
| 1164697033 | Kellie Hebert | Occupational Therapist | 13343 West Main Street, Larose, LA 70373 | 2008-04-23 |
| 1447425319 | Angelle Curole | Specialist/Technologist | 13343 West Main Street, Larose, LA 70373 | 2008-04-23 |
| 1447425335 | Shana Matherne | Occupational Therapy Assistant | 13343 West Main Street, Larose, LA 70373 | 2008-04-23 |
| 1740464973 | Therex | Speech-Language Pathologist | 13343 West Main Street, Larose, LA 70373 | 2007-12-24 |
| Find all providers in zip 70373 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053468512 | Darren J. Duet | Family Medicine | 753 Industrial Park Rd, Larose, LA 70373-5967 | 2007-01-05 |
| 1073977054 | Amanda Olivier Rogers | Family Medicine | 13030 Highway 308, Larose, LA 70373-2001 | 2016-04-06 |
| 1932256542 | Lafourche Parish Hospital Service District No.1 | Family Medicine | 13030 Highway 308, Larose, LA 70345-4143 | 2007-01-04 |
| 1073568341 | Camille Callais Pitre | Family Medicine | 13030 Hwy 308, Larose, LA 70373-2056 | 2006-05-24 |
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| 1578185781 | Prestige Medical Staffing and Marketing | Family Medicine | 4108 Vendome Place, New Orleans, LA 70125 | 2020-05-11 |
| 1487275939 | La Health Solutions-laplace LLC | Family Medicine | 1524 W Airline Hwy, La Place, LA 70068-3725 | 2020-05-06 |
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| 1780219907 | Shirley Ann Burns | Family Medicine | 1201 South St, Vinton, LA 70668-4509 | 2020-03-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.