Jackson, Russell
Jackson, Russell is an individual health care provider with primary practice located at 55 Fogg Rd , South Weymouth MA 02190-2432. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Jackson, Russell can be contacted via phone (781) 337-7011.Contact Information
Primary practice address
55 Fogg Rd
South Weymouth MA 02190-2432
Phone: (781) 337-7011
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 38477 | Massachusetts |
Profile Details
| NPI number | 1457339517 |
|---|---|
| LBN Legal business name | Jackson, Russell |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 8th, 2006 |
| Last updated | Jul 8th, 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.
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