Provider Demographics
NPI:1982694972
Name:THORNTON, LAURINE L (MD)
Entity Type:Individual
Prefix:
First Name:LAURINE
Middle Name:L
Last Name:THORNTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:460 TOTTEN POND RD
Mailing Address - Street 2:C O MZI
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1906
Mailing Address - Country:US
Mailing Address - Phone:781-890-9933
Mailing Address - Fax:781-890-9950
Practice Address - Street 1:88 WASHINGTON ST
Practice Address - Street 2:ATTN EMERGENCY DEPT
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2465
Practice Address - Country:US
Practice Address - Phone:508-828-7108
Practice Address - Fax:508-828-7158
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-21
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA794142083A0300X, 207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6000094OtherHPHC
MA007047OtherTUFTS
MA0122441Medicaid
MAJ16910OtherBCBS
MA6000094OtherHPHC
MAJ16910OtherBCBS