Individual
DR. MARK A JACKOWITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3640 MAIN ST, SUITE 205, SPRINGFIELD, MA 01107-1145
(413) 739-7367
(413) 737-2686
Mailing address
3640 MAIN ST, SUITE 205, SPRINGFIELD, MA 01107-1145
(413) 739-7367
(413) 737-2686
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
57126
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0034216003
CIGNA
MA
01
—
010057126MA01
CONNECTICUT BLUE SHIELD
MA
01
—
0115328
AETNA GROUP NO.
MA
01
—
032587
CONNECTICARE
MA
01
—
0804490
UNITED HEALTH CARE
MA
01
—
13334
HEALTH NEW ENGLAND
MA
01
—
150664
HARVARD PILGRIM
MA
01
—
180012328
RAILROAD MEDICARE
MA
01
—
J06214
MASS BLUE SHIELD
MA
01
—
P1500300
OXFORD HEALTH PLANS
MA
Enumeration date
09/16/2005
Last updated
05/23/2014
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