Provider Demographics
NPI:1194735449
Name:BODKHE & DICKEY ASSOCIATES, LLC
Entity type:Organization
Organization Name:BODKHE & DICKEY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFERSON
Authorized Official - Middle Name:
Authorized Official - Last Name:DICKEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:413-772-6040
Mailing Address - Street 1:PO BOX 910
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01302-0910
Mailing Address - Country:US
Mailing Address - Phone:413-772-8500
Mailing Address - Fax:413-772-8900
Practice Address - Street 1:51 SANDERSON ST STE 10
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-2739
Practice Address - Country:US
Practice Address - Phone:413-772-6040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA75064207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA61318OtherHARVARD PILGRIM
MABOJ12140OtherBC LOCAL TEAMSTERS
MA20471OtherBMC HEALTHNET
MA0320978Medicaid
MA075064OtherTUFTS
VT1011419Medicaid
MAP00125351OtherRR MEDICARE
MA075064OtherCIGNA
MAJ12140OtherBC/BS MA
MA3089703Medicaid
MA61318OtherHARVARD PILGRIM
MA075064OtherCIGNA
MA075064OtherTUFTS
MA3089703Medicaid