1083764195 NPI number — DR. JOHN F BURTON M.D.

Table of content: DR. JOHN F BURTON M.D. (NPI 1083764195)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083764195 NPI number — DR. JOHN F BURTON M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BURTON
Provider First Name:
JOHN
Provider Middle Name:
F
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083764195
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
510 NORTH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSFIELD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01201-4111
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-443-4800
Provider Business Mailing Address Fax Number:
413-442-9701

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
510 NORTH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSFIELD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01201-4111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-443-4800
Provider Business Practice Location Address Fax Number:
413-442-9701
Provider Enumeration Date:
01/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  48706 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000020943 . This is a "HEALTHNET PLAN PIN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 042714479 . This is a "UNITED HEALTHCARE PIN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 10925 . This is a "HN PIN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 441041175 . This is a "PALMETTO GBA RR PIN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 776514 . This is a "TU PIN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2872348-001 . This is a "CIGNA PIN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 042714479 . This is a "FIRST HEALTH PIN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 04588 . This is a "MVP PIN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: I22280 . This is a "BS PIN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0156485 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 042714479 . This is a "TRICARE PIN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 042714479 . This is a "GHI PIN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0482720 . This is a "AETNA PIN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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