Bobbie Sue Jackson, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

018346 Issued in LA

Practice address

2308 S Range Ave
Denham Springs, LA 70726-5216

Phone

(225) 664-5099

NPI assigned

Mar 28, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Bobbie Sue McCoy Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301270400000",
    "number": "1750680955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19910 STONEHILL DR",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707267673",
            "telephone_number": "225-664-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2308 S RANGE AVE",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707265216",
            "telephone_number": "225-664-5099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BOBBIE",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-28",
        "last_updated": "2011-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "018346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BOBBIE",
            "last_name": "MCCOY",
            "middle_name": "SUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Jamarcus Jackson
• Kalvinesha Jackson
• Rachael Mayer Jackson, MD

• Pharmacist in Denham Springs, LA
• Providers in Denham Springs, LA by specialty
• Pharmacist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.