Basic Information
| Provider Information | |||||||||
| NPI: | 1174866024 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | ORTHOPOULOS | ||||||||
| FirstName: | GEORGIOS | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 280 CHESTNUT STREET | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011991001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137945700 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2 MEDICAL CENTER DRIVE | ||||||||
| Address2: | SUITE 308 | ||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137947020 | ||||||||
| FaxNumber: | 4137942670 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2013 | ||||||||
| LastUpdateDate: | 07/25/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 274893 | MA | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.