Byron Reynard Jackson Sr.
Driver in Amite, LA. Individual provider (NPI-1).
NPI number1982304887
StatusActive
Last updated in NPPESMar 8, 2023
Details
- NPI
- 1982304887
- Entity type
- Individual (NPI-1)
- Name
- Byron Reynard Jackson Sr.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 8, 2023
- Certification date
- Mar 8, 2023
- Last updated
- Mar 8, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 172A00000X | Driver | 005750531 | LA | Yes |
Practice location
661 Sawmill RdAmite, LA 70422-6630
Phone 504-319-8430
Mailing address
661 Sawmill RdAmite, LA 70422-6630
Phone 504-319-8430
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Driver providers in Amite, LA
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.