Organization
SPRINGFIELD EYE ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK A JACKOWITZ M.D. (PRESIDENT)
(413) 739-7367
Entity
Organization
Contact information
Practice address
3640 MAIN ST, SUITE 205, SPRINGFIELD, MA 01107-1145
(413) 739-7367
(413) 739-3808
Mailing address
3640 MAIN ST, SUITE 205, SPRINGFIELD, MA 01107-1145
(413) 739-7367
(413) 739-3808
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011538
AETNA GROUP #
MA
01
—
718778
TUFTS GROUP #
MA
01
—
M10812
MASS BLUE SHIELD GROUP #
MA
Enumeration date
07/28/2006
Last updated
11/11/2010
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