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Contact Information

DAVID K JACKSON, PHD MSCP
200 HENRY CLAY AVE
NEW ORLEANS, LA70118-5911
 Phone: 504-896-7272
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Prescribing (Medical)

103TP0016X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for DAVID K JACKSON · (Male)

NPI # 1053464339
Status Active
Credentials PHD MSCP
Entity Individual
Enumeration date 01/19/2007
Last updated 05/07/2008 - About 18 years ago
Sole proprietor 1 Yes
Identifiers
  • LA License # 694MP
  • LA Medicaid 1677833
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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