Individual
DR. J PHILIP KISTLER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, VBK 802, BOSTON, MA 02114-2621
(617) 726-8459
(617) 726-5043
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
38279
MA
2084N0400X
Neurology Physician
38279
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
038279
TUFTS HEALTH PLAN
MA
05
—
2066858
—
MA
01
—
M08997
BCBS MA
MA
Enumeration date
11/17/2005
Last updated
09/11/2025
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