DR. BYRON ANDRA JACKSON (NPI# 1821167263) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821167263 |
| Entity Type | Individual |
| Full Name | DR. BYRON ANDRA JACKSON |
| Credential | M.D. |
| Practice Address |
745 Olive St Suite 203 Shreveport LA 71104-2246 |
| Mailing Address |
Po Box 4587 Shreveport LA 71134-0587 |
| Practice Telephone | 3182212054 |
| Mailing Telephone | 3182210206 |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 08028R | LA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225667264 | Byron Jackson | Community/Behavioral Health | 3101 N Central Ave # 220b, Phoenix, AZ 85012-2645 | 2020-04-02 |
| 1205133030 | Byron Jackson I | Chiropractor | 6009 Landerhaven Dr, C2, Mayfield Heights, OH 44124-4192 | 2011-02-14 |
| 1265516447 | Byron Jackson | Podiatrist | 6941 N Trenholm Rd, H1, Columbia, SC 29206-1715 | 2006-10-25 |
| Street Address |
745 OLIVE ST SUITE 203 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71104-2246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447242680 | Henry Edward Wood Jr. | Internal Medicine | 745 Olive St, Ste 200, Shreveport, LA 71104-2246 | 2005-08-15 |
| 1356713440 | Delta Nephrology LLC | Internal Medicine | 745 Olive St, Suite 200, Shreveport, LA 71104-2246 | 2015-10-28 |
| 1891105151 | Kristy Anne Lynn | Acupuncturist | 745 Olive St, Suite 212, Shreveport, LA 71104-2246 | 2014-05-07 |
| 1700120524 | Shreveport Prosthetics, Inc. | Prosthetic/Orthotic Supplier | 745 Olive St, Shreveport, LA 71104-2246 | 2012-11-16 |
| 1164730396 | Peterson Counseling Services, LLC | Counselor | 745 Olive St, Suite 109b, Shreveport, LA 71104-2246 | 2010-09-22 |
| 1568784031 | Medrx Inc | Pharmacy | 745 Olive St, Suite 201, Shreveport, LA 71104-2246 | 2010-02-24 |
| 1225225782 | Nancy Poshedley Alexander | Nurse Practitioner | 745 Olive St, Suite 200, Shreveport, LA 71104-2246 | 2007-09-28 |
| 1861682205 | Mary Rocks Zapczynski | Nurse Practitioner | 745 Olive St, Suite 200, Shreveport, LA 71104-2246 | 2007-08-01 |
| 1992925135 | Shreveport Surgery Center Ptrshp | Anesthesiology | 745 Olive St, Suite 100, Shreveport, LA 71104-2246 | 2007-04-30 |
| 1679792014 | Fred A. Lord Jr. | Nurse Anesthetist, Certified Registered | 745 Olive St, Suite 100, Shreveport, LA 71104-2246 | 2007-04-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326582263 | Dana Jackson | Counselor | 2425 Youree Drive, Shreveport, LA 71104 | 2016-12-12 |
| 1154772929 | Belena Cawthorne | Case Manager/Care Coordinator | 2040 Southern Ave, Shreveport, LA 71104 | 2016-06-23 |
| 1437505286 | Courtney Espenan | Counselor | 3825 Gilbert Dr Ste 124, Shreveport, LA 71104 | 2016-05-11 |
| 1215390497 | Joshua Mitchell | Counselor | 1106 Dalzell Street, Shreveport, LA 71104 | 2016-04-04 |
| 1699135426 | Amy Lutricia Krohn | Counselor | 1041 Dalzell St, Shreveport, LA 71104 | 2016-03-07 |
| 1225497779 | Annie Redding II | Counselor | 2525 Youree Dr Suite 110, Shreveport, LA 71104 | 2016-02-12 |
| 1891152328 | Council On Alcoholism and Drug Abuse of Northwest Louisiana | Community/Behavioral Health | 2000 Fairfield Ave, Shreveport, LA 71104 | 2016-01-28 |
| 1922465731 | Marteze Singleton | Case Manager/Care Coordinator | 2525 Youree Dr Ste 10, Shreveport, LA 71104 | 2016-01-25 |
| 1891160297 | Damara Mora | Counselor | 2620 Centenary Blvd Bldg3 Ste 312, Shreveport, LA 71104 | 2015-12-10 |
| 1962876250 | Chastity Shermaine Graham | Counselor | 2620 Centenary Blvd Ste 312, Shreveport, LA 71104 | 2015-11-24 |
| Find all providers in zip 71104 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790315026 | Cody Tingle Md LLC | Internal Medicine | 535 Pierremont Rd, Shreveport, LA 71106-2207 | 2020-01-26 |
| 1538654306 | Masri Group LLC | Internal Medicine | 3801 Creswell Ave Unit 19, Shreveport, LA 71106-1257 | 2018-06-25 |
| 1982106456 | Hudson Amc LLC | Internal Medicine | 1800 Irving Place, Shreveport, LA 71101 | 2018-03-01 |
| 1760923064 | Martin Marak | Internal Medicine | 847 Prospect St, Shreveport, LA 71104-3025 | 2017-03-20 |
| 1265883482 | Vari LLC | Internal Medicine | 506 Rock Hollow Dr, Shreveport, LA 71115-2502 | 2016-06-29 |
| 1598140121 | Mihir V Patel Md LLC | Internal Medicine | 9930 Loveland Ct, Shreveport, LA 71106-7795 | 2015-07-24 |
| 1619357209 | Chad Michael Gibson | Internal Medicine | 8001 Youree Dr Ste 4007, Shreveport, LA 71115-2302 | 2015-06-09 |
| 1265829394 | Amanda Lynn Callegan-poche' | Internal Medicine | 1023 Provenance Pl Ste 130, Shreveport, LA 71106-7796 | 2015-04-15 |
| 1699017681 | Deanna Elise Mossallati | Internal Medicine | 8551 Greenwood Rd, Suite 410, Shreveport, LA 71103 | 2013-03-18 |
| 1477807980 | Ronald Baylis George | Internal Medicine | 1821 Willow Point Drive, Shreveport, LA 71119 | 2012-11-06 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71104 |
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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.