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Contact Information

ELISHA J JACKSON, MD
333 CEDAR ST
NEW HAVEN, CT06510-3206
 Phone: 203-432-4771
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Urogynecology and Reconstructive Pelvic Surgery

207VF0040X 16 Physician/Obstetrics & Gynecology
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for ELISHA J JACKSON · (Female)

NPI # 1346506482
Status Active
Credentials MD
Entity Individual
Enumeration date 04/03/2012
Last updated 08/01/2025 - About 10 months ago
Sole proprietor 1 No
Identifiers
  • TX License # 81231
Hospital affiliation(s)
  • UNIVERSITY OF TEXAS MEDICAL BRANCH GAL - (Acute Care)
    301 UNIVERSITY BOULEVARD
    GALVESTON, TX 77555
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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