Provider Demographics
NPI:1982634663
Name:MEDICAL SPECIALISTS OF TAUNTON, P.C.
Entity Type:Organization
Organization Name:MEDICAL SPECIALISTS OF TAUNTON, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNAMEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-824-5865
Mailing Address - Street 1:72 WASHINGTON ST
Mailing Address - Street 2:SUITE 1300
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-2480
Mailing Address - Country:US
Mailing Address - Phone:508-824-5865
Mailing Address - Fax:508-823-9108
Practice Address - Street 1:72 WASHINGTON ST
Practice Address - Street 2:SUITE 1300
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2480
Practice Address - Country:US
Practice Address - Phone:508-824-5865
Practice Address - Fax:508-823-9108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MACH5365OtherRAILROAD MEDICARE
MA9704001Medicaid
MA686678OtherTUFTS HEALTH PLAN
MAM17564OtherBLUE SHIELD
MAM20867Medicare ID - Type Unspecified
MAM17564OtherBLUE SHIELD