Table of content for
DR.
HUGH
AUCHINCLOSS
MD (NPI 1689655664)
GeneralOrganization/Personal Information
| Employer Identification Number (EIN) | : | |
| Provider Organization Name (Legal Business Name) | : | |
| Provider Last Name (Legal Name) | : | AUCHINCLOSS |
| Provider First Name | : | HUGH |
| Provider Middle Name | : | |
| Provider Name Prefix Text | : | DR. |
| Provider Name Suffix Text | : | |
| Provider Credential Text | : | MD |
| 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 | : | 1689655664 |
| Entity Type Code | : | Individual |
| Replacement NPI | : | |
| Last Update Date | : | 07/08/2007 |
| NPI Deactivation Reason Code | : | |
| NPI Deactivation Date | : | |
| NPI Reactivation Date | : | |
Provider's Business Mailing Address
| Provider First Line Business Mailing Address | : | PO BOX 9142 |
| Provider Second Line Business Mailing Address | : | MASS GENERAL PHYSICIAN ORGANIZATION |
| Provider Business Mailing Address City Name | : | CHARLESTOWN |
| Provider Business Mailing Address State Name | : | MA |
| Provider Business Mailing Address Postal Code | : | 021299142 |
| Provider Business Mailing Address Country Code | : | US |
| Provider Business Mailing Address Telephone Number | : | 6177240287 |
| Provider Business Mailing Address Fax Number | : | 6177262894 |
Provider's Practice Location Mailing Address
| Provider First Line Business Practice Location Address | : | 15 PARKMAN ST |
| Provider Second Line Business Practice Location Address | : | WAC 478 |
| Provider Business Practice Location Address City Name | : | BOSTON |
| Provider Business Practice Location Address State Name | : | MA |
| Provider Business Practice Location Address Postal Code | : | 021143117 |
| Provider Business Practice Location Address Country Code | : | US |
| Provider Business Practice Location Address Telephone Number | : | 6177268418 |
| Provider Business Practice Location Address Fax Number | : | |
| Provider Enumeration Date | : | 11/08/2005 |
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: 208600000X
, with the licence number: 52987
, registered in the state of MA
.
Other Provider's Identifiers (legacy, non-NPI)
- Identifier: J03966
, issued by the state of ( MA )
.
This identifiers is of the category "".
- Identifier: D75148
.
This identifiers is of the category "".
- Identifier: 3002098
, issued by the state of ( MA )
.
This identifiers is of the category "".
- Identifier: 708916
. This is a "TUFTS HEALTH PLAN" identifier
, issued by the state of ( MA )
.
This identifiers is of the category "".
- Identifier: J03966
. This is a "BCBS MA" identifier
, issued by the state of ( MA )
.
This identifiers is of the category "".
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