Individual
DR. DANIEL L JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
49 ROBINWOOD AVE, BOSTON, MA 02130-2156
(617) 390-1204
(617) 390-1584
Mailing address
115 LOWELL AVE, NEWTONVILLE, MA 02460-1521
(617) 390-1204
(617) 390-1584
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
37404
MA
Other
Enumeration date
11/08/2006
Last updated
07/08/2007
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