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NPI 1053914754

IndividualActive

Lavar Jackson

NPI 1053914754 · Transportation Broker · Madison, MS

Provider details

NPI number: 1053914754
Entity type: Individual
Primary specialty: Transportation BrokerTransportation Services
Sex: Male
Sole proprietor: Yes

Practice location

820 Annandale Rd

Madison, MS 39110-7827

Phone: (504) 250-1316

More MS providers

Mailing address

820 Annandale Rd

Madison, MS 39110-7827

Registry dates

Enumerated: 2020-11-17
Last updated: 2020-11-17

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Lavar Jackson — NPI 1053914754, Madison, MS | NPI Central