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NPI Code Detail

MEDICARE: DR. VERA E JACKSON M.D.

MEDICARE:  DR. VERA E 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
1208D00000XGeneral Practice Physician39571MA

General Provider Information

NPI Number : 1598706541
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VERA E JACKSON M.D.
Provider Business Mailing Address
First Line : 178 COUNTY ST
Second Line : #1
City : ATTLEBORO
State : MA
Zip : 02703-3636
Country : US
Telephone Number : 508-222-4423
Fax Number :
Provider Business Practice Location Address
First Line : 200 MAY ST
Second Line :
City : SOUTH ATTLEBORO
State : MA
Zip : 02703-5520
Country : US
Telephone Number : 508-838-2212
Fax Number : 508-838-2200
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2006
Last Update Date : 07/08/2007

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Directions to “ DR. VERA E JACKSON M.D.” Practice Location

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