Jackson, Carl-Christian Andrew

Jackson, Carl-Christian Andrew is an individual health care provider with primary practice located at 750 Washington St Tufts-Nemc #344, Boston MA 02111-1526. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), Allopathic & Osteopathic Physicians / Pediatric Surgery. Allopathic & Osteopathic Physicians / Pediatric Surgery is his primary health care specialty. Jackson, Carl-Christian Andrew can be contacted via phone (617) 636-5025.

Contact Information

Primary practice address
750 Washington St Tufts-Nemc #344 Boston MA 02111-1526
Phone: (617) 636-5025
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 036-106668 Illinois
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X A88272 California
Allopathic & Osteopathic Physicians / Pediatric Surgery 2086S0120X 231415 Massachusetts

Profile Details

NPI number 1235355173
LBN Legal business name Jackson, Carl-Christian Andrew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2007
Last updated Sep 8th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235355173 NPPES
California MEDICAID 00A882720

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