Provider Demographics
NPI:1578539755
Name:AUFRANC, ST GEORGE TUCKER (MD)
Entity Type:Individual
Prefix:
First Name:ST GEORGE
Middle Name:TUCKER
Last Name:AUFRANC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2200
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031-4200
Mailing Address - Country:US
Mailing Address - Phone:603-673-9411
Mailing Address - Fax:603-673-9899
Practice Address - Street 1:830 BOYLSTON ST
Practice Address - Street 2:SUITE 205
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02467-2503
Practice Address - Country:US
Practice Address - Phone:617-739-2003
Practice Address - Fax:617-734-0242
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA32245207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA032245OtherTUFTS
MA2504783OtherAETNA
MA172451OtherHARVARD PILGRIM
MAM08573OtherBLUE CROSS OF MA
MA28776OtherFALLON COMM HEALTH PLAN
MA2043033Medicaid
MA172451OtherHARVARD PILGRIM
MA28776OtherFALLON COMM HEALTH PLAN