Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jack Sutton Fenner

Individual provider Athletic Trainer · NPI 1205629672

Jack Sutton Fenner is an Athletic Trainer in Shreveport, Louisiana. Practices as a sole proprietor. Licensed in Louisiana.

Licensed in
LA
In the registry since
2025

Practice location Address checks out

427 Prestonwood Dr
Shreveport, LA 71115-3723
Phone: (318) 344-3686
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 012122580 (LA)

Record details

NPI number1205629672
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 27, 2025
Last updated in NPPESMay 27, 2025
Certification dateMay 27, 2025

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