Bridgewater Goddard Park Medical Associates Podiatry Division
Healthcare Provider in Brockton, Massachusetts
1962686329- Practice location
- 110 Liberty St, Brockton, MA 02301-5521
- Phone
- 508-894-0400
- Fax
- 508-565-0157
- Last updated
- May 23, 2012
Bridgewater Goddard Park Medical Associates Podiatry Division is a healthcare organization based in Brockton, MA. Bridgewater Goddard Park Medical Associates Podiatry Division practices in Brockton, MA. The NPI Number for Bridgewater Goddard Park Medical Associates Podiatry Division is 1962686329 and holds a License No. 1715 (MA). The current practice location address for Bridgewater Goddard Park Medical Associates Podiatry 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
- 1962686329
- Provider Name
- Bridgewater Goddard Park Medical Associates Podiatry 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
- Healthcare Provider · 213ES0131X
- 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 - City
- Brockton
- State
- Massachusetts
- Zip
- 02301-5521
- Phone Number
- 508-894-0400
- Fax Number
- 508-565-0157
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
- 1715
- License State
- MA
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 Bridgewater Goddard Park Medical Associates Podiatry Division?
The NPI number of Bridgewater Goddard Park Medical Associates Podiatry Division is 1962686329. 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 Podiatry Division?
Bridgewater Goddard Park Medical Associates Podiatry Division is registered under the primary taxonomy Healthcare Provider (code 213ES0131X), licensed in MA under license number 1715.
Where does Bridgewater Goddard Park Medical Associates Podiatry 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 1962686329 directly on the NPPES registry website.