Organization
VISION SOURCE OF AMHERST AND GREENFIELD
Active
Other names
None
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN WINFIELD WADMAN O.D. (OPTOMETRIST/PRESIDENT)
(413) 772-2571
Entity
Organization
Contact information
Practice address
489 BERNARDSTON RD, SUITE 101, GREENFIELD, MA 01301-1238
(413) 772-2571
(413) 772-2266
Mailing address
489 BERNARDSTON RD, SUITE 101, GREENFIELD, MA 01301-1238
(413) 772-2571
(413) 772-2266
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3258
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000021735
HEALTHNET BOSTON MEDICAL
MA
05
—
0353787
—
MA
01
—
17524
HEALTH NEW ENGLAND
MA
01
—
409258
MEDICARE ID-TYPE UNSPECIFIED
MA
01
—
Y70858
BC/BS OF MA
MA
Enumeration date
01/07/2011
Last updated
01/14/2012
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