MEDICARE: ALAN M JACKSON MD

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	50900	MA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	J02952	OTHER		MEDICARE B
6	110048763	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	0400963	OTHER	EVERCARE
2	AA1209	OTHER	HARVARD PILGRIM HEALTHCAR
3	J02952	OTHER	BLUE CARE ELECT
5	043058466	OTHER	HEALTHCARE VALUE MGMT
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	934961	OTHER	FIRST HEALTH
9	042472266	OTHER	PRIVATE HEALTHCARE SYSTEM
10	J02952	OTHER	BLUE SHIELD HMO BLUE
11	042472266	OTHER	ONE HEALTH PLAN
12	4034907	OTHER	AETNA US HEALTHCARE
13	8465722	OTHER	CIGNA HEALTH PLAN
14	8758	OTHER	FALLON COMMUNITY HEALTH P
15	29186	OTHER	HEALTHY START
16	29186	OTHER	CHILDRENS MED SEC PLAN
17	784239	OTHER	MVP HEALTH CARE
18	J02952	OTHER	BLUE SHIELD INDEMNITY

General Provider Information

NPI Number	:	1871557520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAN M JACKSON MD

Provider Business Mailing Address
First Line	:	9 INDUSTRIAL RD STE 5
Second Line	:
City	:	MILFORD
State	:	MA
Zip	:	01757-3736
Country	:	US
Telephone Number	:	508-473-1480
Fax Number	:	508-473-2709

Provider Business Practice Location Address
First Line	:	200 COMMERCE DR
Second Line	:
City	:	NORTHBRIDGE
State	:	MA
Zip	:	01534-1425
Country	:	US
Telephone Number	:	508-731-2575
Fax Number	:	82-660-6085

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

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	09/03/2025

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