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

Mr. Christopher Carl Jackson, PHYSICALTHERAPIST

Individual provider Physical Therapist · NPI 1972009041

Mr. Christopher Carl Jackson, PHYSICALTHERAPIST is a Physical Therapist in Private Practice in Longville, Louisiana. Qualified in 2005, 21 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
21
Licensed in
LA
In the registry since
2018

Practice location Address checks out

12739 Highway 171 Ste B
Longville, LA 70652-5050
Phone: (337) 317-9290
Fax: (337) 725-4457
Show map & directions

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

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 06912 (LA)

Record details

NPI number1972009041
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICALTHERAPIST
Sole proprietorYes
NPI enumeratedApril 5, 2018
Last updated in NPPESFebruary 17, 2021
Certification dateFebruary 17, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Longville