Healthcare Provider Details

I. General information

NPI: 1386758878
Provider Name (Legal Business Name): GOLD OPHTHALMOLOGIC ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 10/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 MAIN ST SUITE 9
GREAT BARRINGTON MA
01230-2148
US

IV. Provider business mailing address

780 MAIN ST SUITE 9
GREAT BARRINGTON MA
01230-2148
US

V. Phone/Fax

Practice location:
  • Phone: 413-528-3355
  • Fax: 413-528-1077
Mailing address:
  • Phone: 413-528-3355
  • Fax: 413-528-1077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number204444
License Number StateMA

VIII. Authorized Official

Name: DR. JOSEPH B GOLD
Title or Position: PRESIDENT/OWNER
Credential: M.D., F.A.C.S.
Phone: 413-528-3355