Healthcare Provider Details

I. General information

NPI: 1861095945
Provider Name (Legal Business Name): HEYWOOD MEDICAL GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2020
Last Update Date: 06/08/2023
Certification Date: 06/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 HOSPITAL DR
WINCHENDON MA
01475-1820
US

IV. Provider business mailing address

55 HOSPITAL DR
WINCHENDON MA
01475-1820
US

V. Phone/Fax

Practice location:
  • Phone: 978-297-2311
  • Fax:
Mailing address:
  • Phone: 978-297-2311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: THOMAS J SULLIVAN
Title or Position: CEO
Credential:
Phone: 978-630-6157