| Berkshire Mobile Medicine, P.c. | |
|
20 Williamstown Rd Ste 4 Lanesborough MA 01237-9548 | |
| (413) 445-6800 | |
| (413) 707-4959 |
| Full Name | Berkshire Mobile Medicine, P.c. |
|---|---|
| Speciality | Physician Assistant |
| Location | 20 Williamstown Rd Ste 4, Lanesborough, Massachusetts |
| Authorized Official Name and Position | Jeffrey J Kellogg (PRESIDENT) |
| Authorized Official Contact | 4134456800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Berkshire Mobile Medicine, P.c. 20 Williamstown Rd Ste 4 Lanesborough MA 01237-9548 Ph: (413) 445-6800 | Berkshire Mobile Medicine, P.c. 20 Williamstown Rd Ste 4 Lanesborough MA 01237-9548 Ph: (413) 445-6800 |
| NPI Number | 1972853604 |
|---|---|
| Provider Enumeration Date | 09/10/2012 |
| Last Update Date | 08/07/2023 |
| Medicare PECOS PAC ID | 3274785605 |
|---|---|
| Medicare Enrollment ID | O20121212000236 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972853604 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 156843 (Massachusetts) | Secondary |
| 363AM0700X | Physician Assistant - Medical | 1520 (Massachusetts) | Primary |