Individual
DR. TOM JAKSIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
300 LONGWOOD AVE, FEGAN 3, BOSTON, MA 02115-5724
(617) 355-9600
(617) 730-0477
Mailing address
45 TEMPLE ST UNIT 510, BOSTON, MA 02114-4273
(617) 840-1941
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
51940
MA
2086S0102X
Surgical Critical Care Physician
51940
MA
2086S0120X
Pediatric Surgery Physician
Primary
51940
MA
Other
Enumeration date
07/12/2006
Last updated
02/23/2022
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