Provider Demographics
NPI:1912020009
Name:WILLIAMSTOWN ANESTHESIA ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:WILLIAMSTOWN ANESTHESIA ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:MICLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-458-3397
Mailing Address - Street 1:71 HOSPITAL AVE
Mailing Address - Street 2:NORTH ADAMS REGIONAL HOSPITAL
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247
Mailing Address - Country:US
Mailing Address - Phone:413-458-3397
Mailing Address - Fax:
Practice Address - Street 1:71 HOSPITAL AVE
Practice Address - Street 2:NORTH ADAMS REGIONAL HOSPITAL
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247
Practice Address - Country:US
Practice Address - Phone:413-458-3397
Practice Address - Fax:413-458-4255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9770534Medicaid
MAM15775Medicare ID - Type Unspecified