Healthcare Provider Details

I. General information

NPI: 1992296206
Provider Name (Legal Business Name): PHILIP JOHN CLOSE-BARBER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: PHILIP JOHN BARBER

II. Dates (important events)

Enumeration Date: 05/22/2018
Last Update Date: 03/16/2023
Certification Date: 06/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 COUNTY CIR
AMHERST MA
01003-9255
US

IV. Provider business mailing address

111 COUNTY CIR
AMHERST MA
01003-9255
US

V. Phone/Fax

Practice location:
  • Phone: 413-695-2051
  • Fax: 413-545-9602
Mailing address:
  • Phone: 413-545-2337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number293658
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number276343
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: