Healthcare Provider Details

I. General information

NPI: 1306810874
Provider Name (Legal Business Name): WILLIAM H. TRUSWELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 03/09/2022
Certification Date: 03/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 LOCUST ST #2
NORTHAMPTON MA
01060-2018
US

IV. Provider business mailing address

16 RIVERDALE RD
SOUTHAMPTON MA
01073-9435
US

V. Phone/Fax

Practice location:
  • Phone: 413-587-0600
  • Fax: 413-585-5112
Mailing address:
  • Phone: 413-433-0195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number39445
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number39455
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: