Healthcare Provider Details

I. General information

NPI: 1780646927
Provider Name (Legal Business Name): BRIMFIELD FAMILY HEALTH CENTER, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 E OLD STURBRIDGE RD
BRIMFIELD MA
01010-9647
US

IV. Provider business mailing address

255 E OLD STURBRIDGE RD
BRIMFIELD MA
01010-9647
US

V. Phone/Fax

Practice location:
  • Phone: 413-245-3389
  • Fax: 413-245-4553
Mailing address:
  • Phone: 413-245-3389
  • Fax: 413-245-4553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: THOMAS R CLAY
Title or Position: PRESIDENT
Credential: D.O.
Phone: 413-245-3389