MEDICARE: HANNAH B JACKSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD045691	DC

General Provider Information

NPI Number	:	1154733467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH B JACKSON M.D.

Provider Business Mailing Address
First Line	:	2000 N ST NW APT 806
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20036-2820
Country	:	US
Telephone Number	:	617-875-4179
Fax Number	:	617-507-5977

Provider Business Practice Location Address
First Line	:	123 45TH ST NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20019-4632
Country	:	US
Telephone Number	:	202-469-4699
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2014
Last Update Date	:	07/21/2022

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Directions to “ HANNAH B JACKSON M.D.” Practice Location

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