Jackson Fulk-Logon, MD
NPI 1063115780 · Student in an Organized Health Care Education/Training Program · Boston, MA
Jackson Fulk-Logon, MD is a Student in an Organized Health Care Education/Training Program provider in Boston, MA (NPI 1063115780).
Provider details
- NPI number
- 1063115780
- Entity type
- Individual
- Primary specialty
- Student in an Organized Health Care Education/Training ProgramStudent, Health Care
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Student, Health Care
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2023-03-22
- Last updated
- 2023-03-24
- Certified
- 2023-03-24
Frequently asked questions
- What is Jackson Fulk-Logon's NPI number?
- Jackson Fulk-Logon's National Provider Identifier (NPI) is 1063115780, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jackson Fulk-Logon's specialty?
- Jackson Fulk-Logon is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program (Student, Health Care).
- Where is Jackson Fulk-Logon located?
- Jackson Fulk-Logon's practice location on file with NPPES is 330 Brookline Ave, Boston, MA 02215-5491.
- What is Jackson Fulk-Logon's phone number?
- The practice phone number listed in the NPPES registry for Jackson Fulk-Logon is (617) 632-9581.
- Is Jackson Fulk-Logon's NPI active?
- Yes — Jackson Fulk-Logon's NPI (1063115780) is active in the NPPES registry as of the last update on 2023-03-24.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.