MEDICARE: DR. BAYARD D CLARKSON JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	53344	MA
2	2084P0804X	Child & Adolescent Psychiatry Physician	53344	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669463956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BAYARD D CLARKSON JR. MD

Provider Business Mailing Address
First Line	:	PO BOX 9142
Second Line	:	MASS GENERAL PHYSICIAN ORGANIZATION
City	:	CHARLESTOWN
State	:	MA
Zip	:	02129-9142
Country	:	US
Telephone Number	:	617-724-0287
Fax Number	:	617-726-2894

Provider Business Practice Location Address
First Line	:	47 CRAFTS RD
Second Line	:
City	:	CHESTNUT HILL
State	:	MA
Zip	:	02467-1823
Country	:	US
Telephone Number	:	617-730-8174
Fax Number	:	617-277-2844

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2005
Last Update Date	:	09/11/2025

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