Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Jerry D Blackwell Jr Jr., LAT

Individual provider Athletic Trainer · NPI 1598473860

Mr. Jerry D Blackwell Jr Jr., LAT is an Athletic Trainer in Thibodaux, Louisiana. Practices as a sole proprietor. Licensed in Louisiana.

Licensed in
LA
In the registry since
2022
What do these letters mean?
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.

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Practice location Address checks out

2498 Pineridge St
Thibodaux, LA 70301-3959
Phone: (985) 446-7573
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence J00235 (LA)

Record details

NPI number1598473860
Entity typeIndividual (Type 1)
GenderMale
Credentials LAT
Sole proprietorYes
NPI enumeratedNovember 7, 2022
Last updated in NPPESNovember 7, 2022
Certification dateNovember 7, 2022

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