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

Lauran Dekease Jackson

Individual provider Medical Toxicology (Preventive Medicine) Physician · NPI 1063357473

Lauran Dekease Jackson is a Medical Toxicology (Preventive Medicine) Physician in Petersburg, Virginia. Licensed in Virginia. Registered with an NPI since 2026.

Licensed in
VA
In the registry since
2026

Practice location Address checks out

10543 S Crater Rd
Petersburg, VA 23805
Phone: (804) 481-5259
Show map & directions

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

Specialties & licences

Medical Toxicology (Preventive Medicine) Physician (primary) Taxonomy 2083T0002X · Licence 1401115318 (VA)

Record details

NPI number1063357473
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 22, 2026
Last updated in NPPESApril 22, 2026
Certification dateApril 22, 2026
Mailing address10543 South Crater Road, Petersburg, VA 23805