Basic Information
| Provider Information | |||||||||
| NPI: | 1366423907 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BECKWITH | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | W | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 30 | ||||||||
| Address2: | |||||||||
| City: | GREAT BARRINGTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135289311 | ||||||||
| FaxNumber: | 4136440274 | ||||||||
| Practice Location | |||||||||
| Address1: | 780 MAIN STREET | ||||||||
| Address2: | SUITE 104 | ||||||||
| City: | GREAT BARRINGTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135281470 | ||||||||
| FaxNumber: | 4135283167 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/10/2005 | ||||||||
| LastUpdateDate: | 03/30/2018 | ||||||||
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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 | 207V00000X | 223952 | MA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 043517461 | 01 | CHAMPUS | OTHER | 043517461 | 01 | HMC PPO | OTHER | J2889 | 01 | HMO BLUE | OTHER | 7731649 | 01 | AETNA | OTHER | 10098934 | 01 | CAPITAL DISTRICT PHP | OTHER | 2108968 | 05 | MA | MEDICAID | AA31086 | 01 | HARVARD COMM HEALTH | OTHER | 3137730 | 01 | CIGNA | OTHER | 4144072 | 01 | MVP SELECT | OTHER | 110041473A | 05 | MA | MEDICAID | 80314 | 01 | GIC INDEMNITY PLAN | OTHER | I34223 | 01 | MEDICARE UPIN | OTHER | 0035606 | 01 | NEIGHBORHOOD HEALTH | OTHER | 000000030797 | 01 | BMC HEALTH PLAN | OTHER | 36366 | 01 | HEATH NEW ENGLAND | OTHER | 5619731 | 01 | HCVM FIRST HEALTH | OTHER | 87582 | 01 | HEALTHY START | OTHER | J28789 | 01 | BLUE SHIELD | OTHER |