CARL-CHRISTIAN ANDREW JACKSON MD
Individual Provider (NPI-1)
Active
Surgery, Pediatric Surgery
Provider Information
- NPI Number
1235355173- Provider Type
- Individual Provider (NPI-1)
- Credentials
- MD
- Status
- Active
Contact & Location
- Address
- 2 DUDLEY ST STE 190, PROVIDENCE, RI, 029053248
- Phone
- (401) 228-0623
- Fax
- (401) 868-2319
Specialties & Taxonomies
Thoracic Surgery (Cardiothoracic Vascular Surgery)
License: CA #A88272
Surgery, Pediatric Surgery
Primary License: RI #MD18790
Surgery, Pediatric Surgery
License: MA #231415
Surgery
License: IL #036-106668