Individual
DR. REBECCA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
119 NEW ATHOL RD STE 200, ORANGE, MA 01364-9603
(978) 544-7800
Mailing address
119 NEW ATHOL RD STE 200, ORANGE, MA 01364-9603
(978) 544-7800
(978) 544-0023
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
208092
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110083655A
—
MA
01
—
47759
HEALTH NEW ENGLAND
MA
01
—
9611148
AETNA
MA
01
—
AA159101
HARVARD PILGRIM HEALTHCARE
MA
01
—
J23829
BLUE CROSS BLUE SHIELD OF MA
MA
Enumeration date
02/07/2006
Last updated
07/21/2022
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