White, Jacquelyn Kibodeaux

White, Jacquelyn Kibodeaux is an sole proprietor health care provider with primary practice located at 4001 Ridgemont St , Ruston LA 71270-9596. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is her primary health care specialty. White, Jacquelyn Kibodeaux can be contacted via phone (318) 251-8838.

Contact Information

Primary practice address
4001 Ridgemont St Ruston LA 71270-9596
Phone: (318) 251-8838
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X LA201607 Louisiana
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 021607 Louisiana

Profile Details

NPI number 1629186812
LBN Legal business name White, Jacquelyn Kibodeaux
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 28th, 2006
Last updated Dec 7th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1629186812 NPPES
Louisiana MEDICAID 1121991

Popular Providers