Provider Demographics
NPI:1306907415
Name:BRATCHER, JASON MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:MICHAEL
Last Name:BRATCHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 ALPINE TRL
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-8927
Mailing Address - Country:US
Mailing Address - Phone:413-281-8935
Mailing Address - Fax:
Practice Address - Street 1:777 NORTH ST
Practice Address - Street 2:SUITE 203
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4147
Practice Address - Country:US
Practice Address - Phone:413-499-8590
Practice Address - Fax:413-499-6410
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY231621207RG0100X
MA261855207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAS400244397OtherMEDICARE PTAN
NYL19776Medicare UPIN
IN192770B8Medicare PIN
NY0459SZVZP1Medicare PIN
MAS400244397OtherMEDICARE PTAN