Brian W Jack is a Family Medicine in Boston, Massachusetts. Brian W Jack practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Brian W Jack is 1053385120. The last update date is 2014-06-30.
Brian W Jack's current location address is 850 Harrison Ave, Boston, Massachusetts. You can contact this provider via phone number 6174142080 and fax number 6174142090. The mailing address for Brian W Jack is 850 Harrison Ave, Boston, Massachusetts. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Brian W Jack |
|---|---|
| Address | 850 Harrison Ave, Boston, Massachusetts |
| Phone Number | 6174142080 |
| Fax Number | 6174142090 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1053385120 |
|---|---|
| Provider Enumeration Date | 2006-02-15 |
| Last Updated Date | 2014-06-30 |
Provider Mailing Address Detail
| Address | 850 Harrison Ave |
|---|---|
| City | Boston |
| State | Massachusetts (MA) |
| Post Code | 21184001 |
| Phone Number | 6174142080 |
| Fax Number | 6174142090 |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
| Licence No | 154199 |
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Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine i |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 110059621A | MA | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Brian W Jack by the Centers for Medicare & Medicaid Services?
The Brian W Jack has been issued the NPI (National Provider Identifier) 1053385120, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Brian W Jack?
The Brian W Jack is situated at 850 Harrison Ave, in the city of Boston, state of MA, with the zip code 21184001.
What is Brian W Jack's area of expertise and its corresponding taxonomy classification?
The Brian W Jack's field of specialization is Family Medicine, and it falls under the taxonomy code 207Q00000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Brian W Jack receive its 1053385120 assignment from the Centers for Medicare & Medicaid Services?
The Brian W Jack was assigned its 1053385120 by the Centers for Medicare & Medicaid Services on 2006-02-15.
When was the Brian W Jack's information last updated?
The Brian W Jack's information was last updated on 2014-06-30.
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