Healthcare Provider Details

I. General information

NPI: 1972435840
Provider Name (Legal Business Name): JEFFREY TODD CHAMBERLAIN JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2204 S 5TH ST
LEESVILLE LA
71446-5318
US

IV. Provider business mailing address

209 E NORTH LOOP
OAKDALE LA
71463-2053
US

V. Phone/Fax

Practice location:
  • Phone: 337-238-9305
  • Fax:
Mailing address:
  • Phone: 318-306-0386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPST.025537
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: