Individual
JAMES JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2696
(617) 724-4000
Mailing address
55 FRUIT ST, BOSTON, MA 02114-2696
(617) 724-4000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
288868
MA
207Q00000X
Family Medicine Physician
MD46516
IA
2084P0800X
Psychiatry Physician
MD46516
IA
Other
Enumeration date
06/18/2015
Last updated
07/06/2023
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