Provider Demographics
NPI:1811238132
Name:LONGVIEW ORTHOPAEDIC CENTER LLC
Entity Type:Organization
Organization Name:LONGVIEW ORTHOPAEDIC CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-534-6333
Mailing Address - Street 1:100 HOSPITAL RD
Mailing Address - Street 2:SUITE 3C
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-2253
Mailing Address - Country:US
Mailing Address - Phone:978-534-6333
Mailing Address - Fax:978-840-0866
Practice Address - Street 1:100 HOSPITAL RD
Practice Address - Street 2:SUITE 3C
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-2253
Practice Address - Country:US
Practice Address - Phone:978-534-6333
Practice Address - Fax:978-840-0966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM18898OtherBCBS