George Bacall, MD
Individual provider Active NPI Obstetrics & Gynecology Physician · Enfield, CT
NPI 1164519823 · NPPES record last updated Nov 11, 2021
Key facts
- NPI
- 1164519823
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 017896 (CT)
- Practice address
- 170 Hazard Ave
Enfield, CT 06082 - Phone
- (860) 763-4001
- Fax
- (860) 749-5592
- NPI assigned
- Oct 6, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 017896 | CT | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Woodland Women'S Services, L.L.C. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 017896 | CT | Yes |
Addresses
Primary practice location
170 Hazard Ave
Enfield, CT 06082
Mailing address
170 Hazard Ave
Enfield, CT 06082
Phone (860) 763-4001
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001178961 | Medicaid | CT |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | gbacall12497@direct.stfranciscare.org | Direct |
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All providers in Enfield, CT · Obstetrics & Gynecology Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 11, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.