Provider Demographics
NPI:1174866024
Name:ORTHOPOULOS, GEORGIOS (MD)
Entity Type:Individual
Prefix:
First Name:GEORGIOS
Middle Name:
Last Name:ORTHOPOULOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 CHESTNUT STREET
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1001
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:2 MEDICAL CENTER DRIVE
Practice Address - Street 2:SUITE 308
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107
Practice Address - Country:US
Practice Address - Phone:413-794-7020
Practice Address - Fax:413-794-2670
Is Sole Proprietor?:No
Enumeration Date:2013-03-28
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA274893208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery