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Carl-Christian Andrew Jackson

Surgeon Pediatric Surgery Cardiothoracic Vascular Surgeon

750 Washington St Tufts-Nemc #344
Boston , Massachusetts 02111-1526

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Carl-Christian Andrew Jackson

Surgeon Pediatric Surgery Cardiothoracic Vascular Surgeon

750 Washington St Tufts-Nemc #344
Boston , Massachusetts 02111-1526

(617) 636-5025

Write a Review Save Call

Carl-Christian Andrew Jackson

Surgeon Pediatric Surgery Cardiothoracic Vascular Surgeon

750 Washington St Tufts-Nemc #344
Boston , Massachusetts 02111-1526

(617) 636-5025 Call

Write a Review Save

About


Features

Language(s) Spoken
English
Ethnic Identity
White / Caucasian

Specialties

  • Surgeon
  • Pediatric Surgery
  • Cardiothoracic Vascular Surgeon

Languages spoken

  • English

Location

750 Washington St Tufts-Nemc #344 Boston , Massachusetts 02111-1526

First Address

  • Carl-Christian Andrew Jackson
  • 750 Washington St Tufts-Nemc #344
  • Boston, MA
  • Zip : 02111-1526
  • Phone : (617) 636-5025

Second Address

  • Carl-Christian Andrew Jackson
  • 750 Washington St Tufts-Nemc #344
  • Boston, MA
  • Zip : 02111-1526
  • Phone : (617) 636-5025

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FAQs


Where did Carl-Christian Andrew Jackson attend graduate school?

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Where did Carl-Christian Andrew Jackson do his residency?

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Where did Carl-Christian Andrew Jackson do his fellowship?

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Is Carl-Christian Andrew Jackson board certified?

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What type of doctor is Carl-Christian Andrew Jackson

Pediatric Surgery

In what state does Carl-Christian Andrew Jackson practice in?

Massachusetts

Where is Carl-Christian Andrew Jackson ’s practice located?

750 Washington St Tufts-Nemc #344 , Boston, Massachusetts, 02111-1526

What is Carl-Christian Andrew Jackson ’s gender?

Male

Is Carl-Christian Andrew Jackson a sole practitioner?

No

Is Carl-Christian Andrew Jackson accepting new patients?

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What languages does Carl-Christian Andrew Jackson speak?

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Does Carl-Christian Andrew Jackson accept insurance?

Yes, Carl-Christian Andrew Jackson accepts insurance

Does Carl-Christian Andrew Jackson offers telemedicine?

Carl-Christian Andrew Jackson has not indicated if he offers telemedicine

What is Carl-Christian Andrew Jackson ’s professional license number?

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What is Carl-Christian Andrew Jackson ’s NPI number?

1235355173

Does Carl-Christian Andrew Jackson have any license restrictions?

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Scope of Practice

Primary Taxonomy Code Taxonomy Specialty License Number License State
N 208200000X Surgeon 036-106668 IL
N 208600000X Surgeon 036-106668 IL
Y 2086S0120X Pediatric Surgery 231415 MA
N 208G00000X Cardiothoracic Vascular Surgeon A88272 CA

National Provider Identifier

NPI 1235355173
Provider Name Carl-Christian Andrew Jackson
First Address Boston, MA 02111-1526
Second Address Boston, MA 02111-1526
Gender M
NPI Entity type Individual
Is Sole Proprietor No
Is Organization Subpart N/A
Enumeration Date 18/04/2007
Last Update Date 08/08/2007

Additional Identifiers

IDENTIFIER TYPE / CODE IDENTIFIER STATE
00A882720 (05) CA
I18975 (02) CA

NPI Footnotes


What is the National Provider Identifier (NPI)

The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address

The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address

The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code

The code describing the type of health care provider that is being assigned an NPI. The entity type codes are:
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?

Subparts are the components and separate physical locations of organization health care providers. Subpart examples include: Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name

The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.

Provider Enumeration Date

The date the provider was assigned a unique identifier (assigned an NPI)

Last Update Date

The date that a NPI record was last updated or changed

Primary Taxonomy Code

The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPls the license data is associated to the taxonomy code.

Authorized Official Name

The name of the person authorized to submit the PI application or to officially change data for a health care provider.

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