Individual
SHAWN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
300 LONGWOOD AVE, BOSTON CHILDRENS HOSPITAL, HUNNEWELL BLDG, PAVILION 129, BOSTON, MA 02115-5724
(617) 355-8241
Mailing address
300 LONGWOOD AVE, BADER 3216, BOSTON, MA 02115-5724
(617) 355-8241
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
273433
MA
207LP3000X
Pediatric Anesthesiology Physician
273433
MA
208000000X
Pediatrics Physician
273433
MA
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
273433
MA
Other
Enumeration date
03/25/2015
Last updated
04/24/2023
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