Jackson, Joseph Alexander
Jackson, Joseph Alexander is an sole proprietor health care provider with primary practice located at 1493 Cambridge St Station Landing/Ccad, Cambridge MA 02139-1047. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Jackson, Joseph Alexander can be contacted via phone (781) 306-8655.Contact Information
Primary practice address
1493 Cambridge St Station Landing/Ccad
Cambridge MA 02139-1047
Phone: (781) 306-8655
Fax: (781) 306-8655
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 217374 | Massachusetts |
Profile Details
| NPI number | 1609847631 |
|---|---|
| LBN Legal business name | Jackson, Joseph Alexander |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 28th, 2006 |
| Last updated | Jul 9th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609847631 | NPPES |
| Massachusetts | Other | J26769 | BCBS PROVIDER |
| Massachusetts | MEDICAID | 2020203 | BCBS PROVIDER |
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