Provider Demographics
NPI:1689696924
Name:DICKEY, JEFFERSON HALEY (MD)
Entity Type:Individual
Prefix:MR
First Name:JEFFERSON
Middle Name:HALEY
Last Name:DICKEY
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Gender:M
Credentials:MD
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Mailing Address - Street 1:262 NEW LUDLOW ROAD
Mailing Address - Street 2:CHICOPEE MEDICAL CENTER
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020
Mailing Address - Country:US
Mailing Address - Phone:413-552-3250
Mailing Address - Fax:413-552-3255
Practice Address - Street 1:260 NEW LUDLOW ROAD
Practice Address - Street 2:WESTERN MASS PHYSICIAN ASSOCIATES, INC.
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020
Practice Address - Country:US
Practice Address - Phone:413-534-2622
Practice Address - Fax:413-534-2661
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2012-10-31
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Provider Licenses
StateLicense IDTaxonomies
MA75064207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110092205AMedicaid
MA110092205AMedicaid