Provider Demographics
NPI:1558300442
Name:HAZARD, BESSIE L (MD)
Entity Type:Individual
Prefix:
First Name:BESSIE
Middle Name:L
Last Name:HAZARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 415348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5348
Mailing Address - Country:US
Mailing Address - Phone:800-225-8885
Mailing Address - Fax:508-334-1977
Practice Address - Street 1:1WEST BOYLSTON STREET
Practice Address - Street 2:SUITE 206
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605
Practice Address - Country:US
Practice Address - Phone:508-595-2000
Practice Address - Fax:508-853-7149
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA79784207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
2040310OtherFIRST HEALTH
380001156OtherRAILROAD MEDICARE
042472266OtherPRIVATE HEALTHCARE SYSTEM
042472266OtherHEALTHCARE VALUE MANAGEME
991266OtherFALLON COMMUNITY HEALTH
J14967OtherBLUE CARE ELECT
J14967OtherBLUE SHIELD HMO BLUE
0071113OtherCIGNA HEALTH PLAN
042472266OtherTHREE RIVERS
784028OtherMVP HEALTH CARE
MA3134377Medicaid
AA9890OtherHARVARD PILGRIM HEALTHCAR
4589913OtherAETNA US HEALTHCARE
042472266OtherTRICARE CHAMPUS
J14967OtherBLUE SHIELD INDEMNITY
0400887OtherEVERCARE
042472266OtherONE HEALTH PLAN
J14967OtherBLUE CARE ELECT
042472266OtherTHREE RIVERS
MAJ14967Medicare ID - Type Unspecified