Provider Demographics
NPI:1720026685
Name:BASCOMB, JILL M (MD)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:M
Last Name:BASCOMB
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:280 CHESTNUT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1619
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:164 HIGH ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-2613
Practice Address - Country:US
Practice Address - Phone:413-773-2263
Practice Address - Fax:413-773-2127
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2016-03-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA227655207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine