Provider Demographics
NPI:1376542191
Name:UPTON, JOSEPH III (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:UPTON
Suffix:III
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:PO BOX 67191
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-0002
Mailing Address - Country:US
Mailing Address - Phone:617-739-1972
Mailing Address - Fax:617-739-6624
Practice Address - Street 1:822 BOYLSTON ST
Practice Address - Street 2:
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-2595
Practice Address - Country:US
Practice Address - Phone:617-739-1972
Practice Address - Fax:617-739-6624
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2019-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA410252086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM09457OtherBLUE CROSS BLUE SHIELD
MA710353OtherTUFTS
MAB77000BIOtherHARVARD PILGRIM
MAB77000Medicare UPIN
MAM09457Medicare ID - Type UnspecifiedMEDICARE