Dr. Matthew J Jackson
Oral & Maxillofacial Surgeon
243 Charles Street Mass Eye And Ear Infirmary
Boston
, Massachusetts 02114
Dr. Matthew J Jackson
Oral & Maxillofacial Surgeon
243 Charles Street Mass Eye And Ear Infirmary
Boston
, Massachusetts 02114
(617) 726-2894
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About
Features
Specialties
- Oral & Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Dr. Matthew J Jackson
- Po Box 9142 Mass General Physician Organization
- Charlestown, MA
- Zip : 02129-9142
- Fax : (617) 726-2894
- Phone : (617) 724-0287
Second Address
- Dr. Matthew J Jackson
- 243 Charles Street Mass Eye And Ear Infirmary
- Boston, MA
- Zip : 02114
- Fax : (617) 659-4917
- Phone : (617) 573-4306
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgeon | 11607 | MA |
National Provider Identifier
| NPI | 1588647911 |
|---|---|
| Provider Name | Dr. Matthew J Jackson |
| First Address | Charlestown, MA 02129-9142 |
| Second Address | Boston, MA 02114 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/11/2005 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0264822 | (05) | MA |
| 40346 | HARVARD PILGRIM HMO (01) | MA |
| 757863 | TUFTS HEALTH HMO (01) | MA |
| U55712 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
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?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.