Provider Demographics
NPI:1174585426
Name:KITTLER, JASON
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:KITTLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 NORTH ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-4147
Mailing Address - Country:US
Mailing Address - Phone:413-499-8510
Mailing Address - Fax:
Practice Address - Street 1:777 NORTH ST
Practice Address - Street 2:SUITE 207
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4147
Practice Address - Country:US
Practice Address - Phone:413-499-8510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA81381207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA081381OtherTUFTS
MAP00267287OtherRAILROAD MEDICARE
MA000000031944OtherHEALTHNET
MA043531502OtherUHC
MA043531502OtherGIC INDEMNITY
MAJ16311OtherBCBS
MA043531502OtherCIGNA INDEMNITY
MA1468385OtherCIGNA/HEALTHSOURCE
MA10041539OtherCDPHP
MA13617OtherHEALTH NEW ENGLAND
MA3149633Medicaid
MA3149633Medicaid
MA043531502OtherCIGNA INDEMNITY