Provider Demographics
NPI:1184777849
Name:PITTSFIELD MEDICAL & SURGICAL, PA
Entity type:Organization
Organization Name:PITTSFIELD MEDICAL & SURGICAL, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:BARKSDALE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-435-8336
Mailing Address - Street 1:44 LOUDON RD
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03263-3604
Mailing Address - Country:US
Mailing Address - Phone:603-435-8336
Mailing Address - Fax:603-443-5693
Practice Address - Street 1:44 LOUDON RD
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:NH
Practice Address - Zip Code:03263-3604
Practice Address - Country:US
Practice Address - Phone:603-435-8336
Practice Address - Fax:603-443-5693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH82083734Medicaid
NHNH3734Medicare ID - Type Unspecified