Provider Demographics
NPI:1982795365
Name:CANTON PODAITRY ASSOCIATES
Entity Type:Organization
Organization Name:CANTON PODAITRY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAWTON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:781-821-2696
Mailing Address - Street 1:742 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-3039
Mailing Address - Country:US
Mailing Address - Phone:781-821-2696
Mailing Address - Fax:781-821-6282
Practice Address - Street 1:742 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-3039
Practice Address - Country:US
Practice Address - Phone:781-821-2696
Practice Address - Fax:781-821-6282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1437213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY770897Medicare ID - Type UnspecifiedKENNETH A LAWTON DPM
MAY77098Medicare ID - Type UnspecifiedCANTON PODIATRY ASSOCIATE
MAT58662Medicare UPIN
MAT84982Medicare UPIN
MAY70569Medicare ID - Type UnspecifiedLEONARD F PINTO JR DPM