| West Brookfield Family Practice | |
|
46 North Main St West Brookfield MA 01585 | |
| (508) 867-8977 | |
| (508) 867-7361 |
| Full Name | West Brookfield Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 46 North Main St, West Brookfield, Massachusetts |
| Authorized Official Name and Position | Gwen Marie Broz (DOCTOR) |
| Authorized Official Contact | 5088678977 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West Brookfield Family Practice 46 North Main Street West Brookfield MA 01585-1044 Ph: (508) 867-8977 | West Brookfield Family Practice 46 North Main St West Brookfield MA 01585 Ph: (508) 867-8977 |
| NPI Number | 1205032463 |
|---|---|
| Provider Enumeration Date | 06/25/2007 |
| Last Update Date | 06/17/2008 |
| Medicare PECOS PAC ID | 2466509625 |
|---|---|
| Medicare Enrollment ID | O20090407000553 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205032463 | NPI | - | NPPES |
| 219183 | Other | MA | DR WILSON LICENSE |
| 9787364 | Medicaid | MA | |
| 73319 | Other | MA | DR BROZ LICENSE |
| 154490 | Other | MA | DR JONES LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 73319 (Massachusetts) | Primary |
| Provider Name | James C Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285622365 PECOS PAC ID: 1850353731 Enrollment ID: I20041102001044 |
| Provider Name | Gwendolyn M Broz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013091669 PECOS PAC ID: 6002853892 Enrollment ID: I20050413000555 |
| Provider Name | David L Maguire |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992744999 PECOS PAC ID: 9234170291 Enrollment ID: I20050519000681 |
| Provider Name | Angela M Giza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376526608 PECOS PAC ID: 8426142605 Enrollment ID: I20070919000209 |
| Provider Name | Jeffrey J Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437144011 PECOS PAC ID: 1254488414 Enrollment ID: I20090406000422 |