Provider Demographics
NPI:1932504040
Name:FALMOUTH ORTHOPAEDIC CENTER
Entity Type:Organization
Organization Name:FALMOUTH ORTHOPAEDIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:RODRIGUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:207-781-4424
Mailing Address - Street 1:20 NORTHBROOK DR
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-1318
Mailing Address - Country:US
Mailing Address - Phone:207-781-4424
Mailing Address - Fax:207-781-4426
Practice Address - Street 1:20 NORTHBROOK DR
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1318
Practice Address - Country:US
Practice Address - Phone:207-781-4424
Practice Address - Fax:207-781-4426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-31
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME130150000Medicaid
MEMM7366Medicare UPIN
ME1120990001Medicare NSC