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Contact Information

JEAN L JACKSON, MD
2014 WASHINGTON ST
NEWTON, MA02462
 Phone: 617-243-6040
 Fax: 617-243-6924
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Emergency Medicine

207PP0204X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for JEAN L JACKSON · (Female)

NPI # 1700840162
Status Active
Credentials MD
Entity Individual
Enumeration date 04/13/2006
Last updated 01/15/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • MA License # 212899
  • RI License # 07406
  • MA Medicaid 3204821
  • Other J25711 BLUE SHIELD
  • Other 5480 HP
  • Other 212899 TUFTS
Hospital affiliation(s) Not Available
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.

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