Healthcare Provider Details

I. General information

NPI: 1609881168
Provider Name (Legal Business Name): BEVERLY ELIZABETH FAULKNER-JONES MD PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 BROOKLINE AVE BOSTON
BOSTON MA
02215-5400
US

IV. Provider business mailing address

330 BROOKLINE AVE BOSTON
BOSTON MA
02215-5400
US

V. Phone/Fax

Practice location:
  • Phone: 617-667-4380
  • Fax:
Mailing address:
  • Phone: 617-667-4380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number230277
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number230277
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: