Jackson, Deidrya Antoinette Elizabeth

Jackson, Deidrya Antoinette Elizabeth is an individual health care provider with primary practice located at 800 Washington St , Boston MA 02111-1552. She recently has only one registered license in Allopathic & Osteopathic Physicians / Glaucoma Specialist, which is considered as her primary health care specialty. Jackson, Deidrya Antoinette Elizabeth can be contacted via phone (617) 636-5000.

Contact Information

Primary practice address
800 Washington St Boston MA 02111-1552
Phone: (617) 636-5000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Glaucoma Specialist 207WX0009X 278459 Massachusetts

Profile Details

NPI number 1649658931
LBN Legal business name Jackson, Deidrya Antoinette Elizabeth
Credentials MD MPH
Entity Individual
Sole proprietor 1 No
Enumeration date May 7th, 2015
Last updated May 21st, 2019 - about 5 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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