Healthcare Provider Details

I. General information

NPI: 1366423907
Provider Name (Legal Business Name): ANDREW W BECKWITH M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 MAIN STREET SUITE 104
GREAT BARRINGTON MA
01230
US

IV. Provider business mailing address

P.O. BOX 30
GREAT BARRINGTON MA
01230
US

V. Phone/Fax

Practice location:
  • Phone: 413-528-1470
  • Fax: 413-528-3167
Mailing address:
  • Phone: 413-528-9311
  • Fax: 413-644-0274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number223952
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: