Jackson, Vicki Ann
Jackson, Vicki Ann is an individual health care provider with primary practice located at 55 Fruit St Palliative Care Service Fnd 600, Boston MA 02114-2696. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine. Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine is her primary health care specialty. Jackson, Vicki Ann can be contacted via phone (617) 724-9197.Contact Information
Primary practice address
55 Fruit St Palliative Care Service Fnd 600
Boston MA 02114-2696
Phone: (617) 724-9197
Fax: (617) 724-8693
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 156340 | Massachusetts |
| Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine | 207RH0002X | 156340 | Massachusetts |
Profile Details
| NPI number | 1538159710 |
|---|---|
| LBN Legal business name | Jackson, Vicki Ann |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 27th, 2005 |
| Last updated | May 20th, 2026 - about 5 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538159710 | NPPES |
| Massachusetts | Other | 156340 | TUFTS HEALTH PLAN |
| Massachusetts | MEDICAID | 3089030 | TUFTS HEALTH PLAN |
| Massachusetts | Other | J24683 | TUFTS HEALTH PLAN |
| Massachusetts | MEDICAID | 110007490A | TUFTS HEALTH PLAN |
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