Healthcare Provider Details
I. General information
NPI: 1184178386
Provider Name (Legal Business Name): SOUND PHYSICIANS OF MASSACHUSETTS, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/05/2016
Last Update Date: 08/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
575 BEECH ST
HOLYOKE MA
01040-2223
US
IV. Provider business mailing address
5410 MARYLAND WAY SUITE 100
BRENTWOOD TN
37027-5064
US
V. Phone/Fax
- Phone: 413-534-2500
- Fax:
- Phone: 615-377-5658
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBERT
BESSLER
Title or Position: OWNER
Credential:
Phone: 615-377-5658