Provider Demographics
NPI:1811964778
Name:SAVARD, GERALD ERNEST (OD)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:ERNEST
Last Name:SAVARD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 W GROVE ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346-1458
Mailing Address - Country:US
Mailing Address - Phone:508-947-7321
Mailing Address - Fax:508-947-0086
Practice Address - Street 1:511 W GROVE ST
Practice Address - Street 2:SUITE 101
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-1458
Practice Address - Country:US
Practice Address - Phone:508-947-7321
Practice Address - Fax:508-947-0086
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2008-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2318152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0314544Medicaid
P00302956OtherRAILROAD MEDICARE
MA0519010001OtherMEDICARE DME
MAT59209Medicare UPIN
MA151158Medicare ID - Type Unspecified