Healthcare Provider Details

I. General information

NPI: 1265353247
Provider Name (Legal Business Name): JAYLAN LENOIR PHAMD, MBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 JEFFERSON HWY
JEFFERSON LA
70121-2451
US

IV. Provider business mailing address

1514 JEFFERSON HWY
JEFFERSON LA
70121-2451
US

V. Phone/Fax

Practice location:
  • Phone: 504-852-3000
  • Fax:
Mailing address:
  • Phone: 504-852-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License NumberPST.026261
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: