Provider Demographics
NPI:1891861050
Name:ORTHOPEDIC AFFILIATES, INC.
Entity Type:Organization
Organization Name:ORTHOPEDIC AFFILIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:DRISCOLL
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:978-369-5391
Mailing Address - Street 1:54 BAKER AVENUE EXT
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-2137
Mailing Address - Country:US
Mailing Address - Phone:978-369-5391
Mailing Address - Fax:978-369-7661
Practice Address - Street 1:54 BAKER AVENUE EXT
Practice Address - Street 2:SUITE 200
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-2137
Practice Address - Country:US
Practice Address - Phone:978-369-5391
Practice Address - Fax:978-369-7661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA19200OtherFALLON COMMUNITY HP
600190OtherUSFHP
CA9820OtherRAILROAD MEDICARE-PALMETT
MAM14423OtherBCBS-MA
MA600190OtherTUFTS HEALTH PLAN
P0501878OtherGHI PPO
P0501878OtherGHI PPO
CA9820OtherRAILROAD MEDICARE-PALMETT
MAM14423Medicare PIN