Provider Demographics
NPI:1023209186
Name:WILLIAM F. FLYNN JR. MD PC
Entity Type:Organization
Organization Name:WILLIAM F. FLYNN JR. MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:FLYNN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:781-643-6313
Mailing Address - Street 1:22 MILL ST
Mailing Address - Street 2:# 301
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-4784
Mailing Address - Country:US
Mailing Address - Phone:781-643-6313
Mailing Address - Fax:781-643-6316
Practice Address - Street 1:22 MILL ST
Practice Address - Street 2:# 301
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-4784
Practice Address - Country:US
Practice Address - Phone:781-643-6313
Practice Address - Fax:781-643-6316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA32293208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0141291Medicaid
MAM13029OtherBCBS
MA9721851Medicaid
032293OtherTUFTS
MA17-00465OtherUNITED HEALTHCARE
MA8477OtherHARVARD PILGRIM
MAM13029Medicare PIN
MAM13029OtherBCBS