Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SAMUEL JACKSON
Active Sole ProprietorSAMUEL JACKSON is a Psychiatry healthcare provider located in BOSTON, Massachusetts. NPI 1255794160 is currently active in the NPPES registry. Verify at CMS.
Psychiatry · BOSTON, MA
Registration Details
- NPI Number
- 1255794160
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 30, 2016 (10.374815190561 yrs)
- Last Updated
- Oct 3, 2025
- Licenses
-
1023020 (MA)MD61035793 (WA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1 BOSTON MEDICAL CTR PLBOSTON, MA, 021182908Browse MA providers · Browse ZIP 02118
- Phone
- 6174145245
- Primary Specialty
-
Psychiatry
2084P0800X
- Additional Specialty
- Psychiatry
Other Psychiatry Providers in BOSTON, MA
| Name | Credential | NPI |
|---|---|---|
| KALOYAN S TANEV | MD | 1538166889 |
| DR. ALISON FIFE | MD | 1477545143 |
| DR. DAVID MISCHOULON | M.D., PH.D. | 1841286887 |
| DR. JAMES ELTON GROVES | MD | 1013906015 |
| DR. STEVEN LURIA ABLON | MD | 1083604839 |
| DR. GEORGE PAPAKOSTAS | MD | 1588654131 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.