Provider Demographics
NPI:1891835468
Name:JACKSON PARISH HOSPITAL
Entity Type:Organization
Organization Name:JACKSON PARISH HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-395-4223
Mailing Address - Street 1:165 BEECH SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:LA
Mailing Address - Zip Code:71251-2013
Mailing Address - Country:US
Mailing Address - Phone:318-259-4435
Mailing Address - Fax:318-395-4259
Practice Address - Street 1:121 WATTS ST
Practice Address - Street 2:SUITE A, B, E & F
Practice Address - City:JONESBORO
Practice Address - State:LA
Practice Address - Zip Code:71251-2062
Practice Address - Country:US
Practice Address - Phone:318-259-0006
Practice Address - Fax:318-259-5619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA230261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1448231Medicaid
LA1448231Medicaid