Organization
BAYSTATE MEDICAL PRACTICES, INC.
Active
Parent organization
BAYSTATE MEDICAL PRACTICES, INC.
Other names
BMP, Dept of OBGYN
Organization subpart
Yes
Provider details
NPI number
Legal business name
BAYSTATE MEDICAL PRACTICES, INC.
Authorized official
RANDALL L VAILL JR. (MANAGER PROVIDER ENROLLMENT)
(413) 794-7976
Entity
Organization
Contact information
Practice address
759 CHESTNUT ST, SPRINGFIELD, MA 01199-1001
(413) 794-5700
(413) 794-1629
Mailing address
280 CHESTNUT ST, 2ND FLOOR, SPRINGFIELD, MA 01199-1000
(413) 794-5700
(413) 794-1629
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
207VE0102X
Reproductive Endocrinology Physician
—
—
207VM0101X
Maternal & Fetal Medicine Physician
—
—
207VX0201X
Gynecologic Oncology Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LW0102X
Women's Health Nurse Practitioner
—
—
367A00000X
Advanced Practice Midwife
—
—
Other
Enumeration date
12/29/2006
Last updated
02/26/2014
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