Bridgewater Goddard Park Medical Associates Podiatry Division in Brockton - Foot Surgery
Bridgewater Goddard Park Medical Associates Podiatry Division - NPI 1962686329
Bridgewater Goddard Park Medical Associates Podiatry Division is a Foot Surgery in Brockton, Massachusetts. Bridgewater Goddard Park Medical Associates Podiatry Division practices all healthcare services and medical treatments related to Foot Surgery. The NPI Number for Bridgewater Goddard Park Medical Associates Podiatry Division is 1962686329. The last update date is 2012-05-23.
Bridgewater Goddard Park Medical Associates Podiatry Division's current location address is 110 Liberty St, Brockton, Massachusetts. You can contact this provider via phone number 5088940400 and fax number 5085650157. The mailing address for Bridgewater Goddard Park Medical Associates Podiatry Division is 110 Liberty St, Brockton, Massachusetts. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Bridgewater Goddard Park Medical Associates Podiatry Division |
|---|---|
| Address | 110 Liberty St, Brockton, Massachusetts |
| Phone Number | 5088940400 |
| Fax Number | 5085650157 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CEO |
|---|---|
| Authorized Official Name | Hollon Kim |
| Telephone Number | 5089417004 |
NPI Number Detail
| NPI Number | 1962686329 |
|---|---|
| Provider Enumeration Date | 2007-12-20 |
| Last Updated Date | 2012-05-23 |
Provider Mailing Address Detail
| Address | 110 Liberty St |
|---|---|
| City | Brockton |
| State | Massachusetts (MA) |
| Post Code | 23015521 |
| Phone Number | 5088940400 |
| Fax Number | 5085650157 |
Provider's Primary Taxonomy Detail
| Speciality | Foot Surgery |
|---|---|
| Taxonomy | 213Es0131X |
| Licence No | 1715 |
|
Definition: A doctor of podiatric medicine who specializes in performing foot and ankle surgeries. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 110022141E | MA | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Bridgewater Goddard Park Medical Associates Podiatry Division by the Centers for Medicare & Medicaid Services?
The Bridgewater Goddard Park Medical Associates Podiatry Division has been assigned the NPI (National Provider Identifier) 1962686329. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Bridgewater Goddard Park Medical Associates Podiatry Division?
The Bridgewater Goddard Park Medical Associates Podiatry Division is physically situated at 110 Liberty St, in the city of Brockton, state of MA, with the postal code 23015521.
What is Bridgewater Goddard Park Medical Associates Podiatry Division's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Bridgewater Goddard Park Medical Associates Podiatry Division is Foot Surgery, and the taxonomy code that classifies this field of practice is 213Es0131X.
On what date did the Centers for Medicare & Medicaid Services assign the 1962686329 to Bridgewater Goddard Park Medical Associates Podiatry Division?
The Centers for Medicare & Medicaid Services assigned the 1962686329 to Bridgewater Goddard Park Medical Associates Podiatry Division on 2007-12-20.
When was the information related to Bridgewater Goddard Park Medical Associates Podiatry Division most recently updated or refreshed?
The details pertaining to the Bridgewater Goddard Park Medical Associates Podiatry Division, including its address, specialty, and other relevant information, were last updated or refreshed on 2012-05-23.