Greylock Medical Clinic | |
20 Williamstown Rd Ste 4 Lanesborough MA 01237-9548 | |
(413) 445-6800 | |
(413) 707-4959 |
Full Name | Greylock Medical Clinic |
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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 |
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Greylock Medical Clinic 20 Williamstown Rd Ste 4 Lanesborough MA 01237-9548 Ph: (413) 445-6800 | Greylock Medical Clinic 20 Williamstown Rd Ste 4 Lanesborough MA 01237-9548 Ph: (413) 445-6800 |
NPI Number | 1972853604 |
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Provider Enumeration Date | 09/10/2012 |
Last Update Date | 08/07/2023 |
Medicare PECOS PAC ID | 3274785605 |
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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 |