Lifespan Physician Group, INC.
General Practice in Providence, Rhode Island
1407116643- Practice location
- 593 Eddy St, Providence, RI 02903-4923
- Phone
- 401-444-6779
- Fax
- 401-444-6912
- Last updated
- October 7, 2025
Lifespan Physician Group, INC. is a healthcare organization based in Providence, RI. Lifespan Physician Group, INC. practices in Providence, RI. The NPI Number for Lifespan Physician Group, INC. is 1407116643. The current practice location address for Lifespan Physician Group, INC. is 593 Eddy St, Providence, RI 02903-4923 and can be reached out via phone at 401-444-6779 and via fax at 401-444-6912.
Provider Profile Details
- NPI Number
- 1407116643
- Provider Name
- Lifespan Physician Group, INC.
- Provider Entity Type
- Organization
- Address
- 593 Eddy St, Providence, RI 02903-4923
- Phone Number
- 401-444-6779
- Fax Number
- 401-444-6912
- Primary Taxonomy
- General Practice · 208D00000X
- Organization Subpart
- Yes
- Parent Organization
- Lifespan Corporation
- Authorized Official
- Mr. Peter K Markell · Evp & Cfo · 401-444-7914
- Other Names
- Brown Health Medical Group (Doing Business As)
- Provider Enumeration Date
- May 22, 2012
- Last Update Date
- October 7, 2025
- Certification Date
- October 7, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 593 Eddy St
Providence, RI 02903-4923 - City
- Providence
- State
- Rhode Island
- Zip
- 02903-4923
- Phone Number
- 401-444-6779
- Fax Number
- 401-444-6912
Provider Business Mailing Address Details
- Address
- 117 Ellenfield St
Suite 101
Providence, RI 02905-4513 - City
- Providence
- State
- RI
- Zip
- 02905-4513
- Phone Number
- 401-444-6779
- Fax Number
- 401-444-6912
License Information
- Taxonomy (1)
- Surgery · 208600000X
- Taxonomy (2)
- Surgery, Surgical Critical Care · 2086S0102X
- Taxonomy (3)
- Dietitian, Registered · 133V00000X
- Taxonomy (4)
- Colon & Rectal Surgery · 208C00000X
- Taxonomy (6)
- Optometrist · 152W00000X
- Taxonomy (7)
- Surgery, Trauma Surgery · 2086S0127X
- Taxonomy (8)
- Obstetrics & Gynecology · 207V00000X
- Taxonomy (9)
- Transplant Surgery · 204F00000X
- Taxonomy (10)
- Plastic Surgery · 208200000X
- Taxonomy (11)
- Surgery, Surgical Oncology · 2086X0206X
- Taxonomy (12)
- Thoracic Surgery (Cardiothoracic Vascular Surgery) · 208G00000X
- Taxonomy (13)
- Surgery, Pediatric Surgery · 2086S0120X
- Taxonomy (14)
- Anesthesiology, Critical Care Medicine · 207LC0200X
- Taxonomy (15)
- General Practice · 208D00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 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 Lifespan Physician Group, INC.?
The NPI number of Lifespan Physician Group, INC. is 1407116643. It was assigned on May 22, 2012 and is currently active in the NPPES registry.
What is the specialty of Lifespan Physician Group, INC.?
Lifespan Physician Group, INC. is registered under the primary taxonomy General Practice (code 208D00000X).
Where does Lifespan Physician Group, INC. practice?
The practice location is 593 Eddy St, Providence, RI 02903-4923. The office can be reached at 401-444-6779 (phone) or 401-444-6912 (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 1407116643 directly on the NPPES registry website.