Individual provider · Type 1 NPI
Kenneth Marlon Jackson
Driver · Baton Rouge, LA
NPI number
1902612740
Active
Practice location
8630 Antioch Rd
Baton Rouge, LA 70817-6413
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Driver Primary | 172A00000X | 002515859 (LA) |
Driver: A person employed to operate a motor vehicle as a carrier of persons or property.
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About NPI 1902612740
Kenneth Marlon Jackson's National Provider Identifier is 1902612740, issued on Dec 6, 2024. The primary taxonomy on file is Driver (172A00000X), and the practice location is in Baton Rouge, LA. The record was last updated on Dec 6, 2024.