National Provider Identifier Database

JEAN L JACKSON, MD – NPI #1700840162
Pediatric Emergency Medicine

Pediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency department.


Contact Information

JEAN L JACKSON, MD
2014 WASHINGTON ST
NEWTON, MA02462
Phone: 617-243-6040
Fax: 617-243-6924
Website:
Specialty Taxonomy Code
* Pediatric Emergency Medicine 207PP0204X

* Indicates primary specialty

NPI Profile & details for JEAN L JACKSON

NPI Number 1700840162
Credentials MD
Entity Individual
Enumeration date 04/13/2006
Last updated 01/15/2008 - About 18 years ago
Sole proprietor1 No
Identifiers
  • MA License #: 212899
  • RI License #: 07406
  • MA Medicaid: 3204821
  • Other: J25711 BLUE SHIELD
  • Other: 5480 HP
  • Other: 212899 TUFTS
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for JEAN L JACKSON, MD

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