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Individual

LATOYA SHARI JACKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1047
(617) 498-1660
Mailing address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1047
(617) 498-1660

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
0101258909
VA
207V00000X
Obstetrics & Gynecology Physician
Primary
277204
MA

Other

Enumeration date
05/24/2011
Last updated
01/30/2019
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