Provider Demographics
NPI:1659911618
Name:ORTHOPEDIC CARE PHYSICIAN NETWORK, LLC
Entity Type:Organization
Organization Name:ORTHOPEDIC CARE PHYSICIAN NETWORK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DELEGATED OFFICIAL, CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DECOUTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-573-1673
Mailing Address - Street 1:15 ROCHE BROTHERS WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:NORTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02356-1000
Mailing Address - Country:US
Mailing Address - Phone:781-344-3535
Mailing Address - Fax:
Practice Address - Street 1:1 COMPASS WAY STE 202
Practice Address - Street 2:
Practice Address - City:EAST BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02333-1466
Practice Address - Country:US
Practice Address - Phone:781-344-3535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty