Active NPIOrganization

Bridgewater Goddard Park Medical Associates, INC Optometry Division

Optometrist in Brockton, Massachusetts

NPI Number1316121775
Practice location
110 Liberty St, Brockton, MA 02301-5521
Fax
508-565-0157
Last updated
May 23, 2012

Bridgewater Goddard Park Medical Associates, INC Optometry Division is a healthcare organization based in Brockton, MA. Bridgewater Goddard Park Medical Associates, INC Optometry Division practices in Brockton, MA. The NPI Number for Bridgewater Goddard Park Medical Associates, INC Optometry Division is 1316121775 and holds a License No. 3009 (MA). The current practice location address for Bridgewater Goddard Park Medical Associates, INC Optometry Division is 110 Liberty St, Brockton, MA 02301-5521 and can be reached out via phone at 508-894-0400 and via fax at 508-565-0157.

Provider Profile Details

NPI Number
1316121775
Provider Name
Bridgewater Goddard Park Medical Associates, INC Optometry Division
Provider Entity Type
Organization
Address
110 Liberty St, Brockton, MA 02301-5521
Phone Number
508-894-0400
Fax Number
508-565-0157
Primary Taxonomy
Optometrist · 152W00000X
Organization Subpart
No
Authorized Official
Mr. Kim Hollon · Ceo · 508-941-7004
Other Names
Signature Medical Group (Doing Business As)
Provider Enumeration Date
December 20, 2007
Last Update Date
May 23, 2012
NPI Status
Active

Provider Business Practice Location Address Details

Address
110 Liberty St
Brockton, MA 02301-5521
Zip
02301-5521
Phone Number
508-894-0400
Fax Number
508-565-0157
Brockton, MA 02301Get directions →

Provider Business Mailing Address Details

Address
110 Liberty St
Brockton, MA 02301-5521
City
Brockton
State
MA
Zip
02301-5521
Phone Number
508-894-0400
Fax Number
508-565-0157

License Information

License Number
3009
License State
MA
Taxonomy
Optometrist · 152W00000X · Primary

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

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Frequently Asked Questions

What is the NPI number of Bridgewater Goddard Park Medical Associates, INC Optometry Division?

The NPI number of Bridgewater Goddard Park Medical Associates, INC Optometry Division is 1316121775. It was assigned on December 20, 2007 and is currently active in the NPPES registry.

What is the specialty of Bridgewater Goddard Park Medical Associates, INC Optometry Division?

Bridgewater Goddard Park Medical Associates, INC Optometry Division is registered under the primary taxonomy Optometrist (code 152W00000X), licensed in MA under license number 3009.

Where does Bridgewater Goddard Park Medical Associates, INC Optometry Division practice?

The practice location is 110 Liberty St, Brockton, MA 02301-5521. The office can be reached at 508-894-0400 (phone) or 508-565-0157 (fax).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1316121775 directly on the NPPES registry website.

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