Provider Demographics
NPI:1902825862
Name:ALLARD, JEFFREY C (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:C
Last Name:ALLARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 WRIGHT ST
Mailing Address - Street 2:WING MEMORIAL HOSPITAL
Mailing Address - City:PALMER
Mailing Address - State:MA
Mailing Address - Zip Code:01064-1138
Mailing Address - Country:US
Mailing Address - Phone:413-283-7651
Mailing Address - Fax:413-284-5117
Practice Address - Street 1:40 WRIGHT ST
Practice Address - Street 2:WING MEMORIAL HOSPITAL
Practice Address - City:PALMER
Practice Address - State:MA
Practice Address - Zip Code:01064-1138
Practice Address - Country:US
Practice Address - Phone:413-284-5241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA429022085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
710690OtherCONNECTICARE
L15123OtherBLUE CROSS BLUE SHIELD
042902OtherTUFTS COMMUNITY HEALTH PL
2069415OtherNETWORK HEALTH
243418OtherHARVARD PILGRIM
300127953OtherRAILROAD MEDICARE
6639010009OtherCIGNA
MA2069415Medicaid
3547842OtherHEALTHSOURCE CMHC
L15123OtherBLUE CROSS BLUE SHIELD
MA2069415Medicaid