Healthcare Provider Details

I. General information

NPI: 1023153640
Provider Name (Legal Business Name): FAMILY MEDICINE ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 12/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 SPRINGFIELD RD SUITE 1
WESTFIELD MA
01085-1832
US

IV. Provider business mailing address

75 SPRINGFIELD RD SUITE 1
WESTFIELD MA
01085-1832
US

V. Phone/Fax

Practice location:
  • Phone: 413-562-5173
  • Fax:
Mailing address:
  • Phone: 413-562-1670
  • Fax: 413-564-0598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: GEORGE E REYNOLDS
Title or Position: PARTNER
Credential: MD
Phone: 413-562-1670