Healthcare Provider Details

I. General information

NPI: 1649243809
Provider Name (Legal Business Name): JOSEPH B GOLD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 09/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 STOCKBRIDGE RD
GREAT BARRINGTON MA
01230-1233
US

IV. Provider business mailing address

740 WILLIAMS ST
PITTSFIELD MA
01201-7463
US

V. Phone/Fax

Practice location:
  • Phone: 413-528-8848
  • Fax: 413-528-2727
Mailing address:
  • Phone: 413-445-4564
  • Fax: 413-448-2727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: