Individual
JEAN LEIGH JACKSON
Active
Individual
JEAN LEIGH JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
07406
RI
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
212899
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
212899
TUFTS
—
05
—
3204821
—
MA
01
—
5480
HP
—
01
—
J25711
BLUE SHIELD
—
Enumeration date
04/13/2006
Last updated
01/15/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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