| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 66 Main St, Wakefield, Rhode Island |
| Authorized Official Name and Position | John Leon Bossian (PHYSICIAN) |
| Authorized Official Contact | 4017891600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
66 Main St Wakefield RI 02879-3555 Ph: (401) 789-1600 | 66 Main St Wakefield RI 02879-3555 Ph: (401) 789-1600 |
| NPI Number | 1922120054 |
|---|---|
| Provider Enumeration Date | 04/06/2007 |
| Last Update Date | 06/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922120054 | NPI | - | NPPES |
| MS46923 | Other | RI | OTHER |
| MS46923 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | DO0391 (Rhode Island) | Primary |
Green Line Express Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 245 Main St, Wakefield, RI 02879 Phone: 401-360-3500 | |
South County Internal Medicine, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 481 Kingstown Rd, Wakefield, RI 02879 Phone: 401-789-0283 Fax: 401-789-0314 | |
Family Doctor Plus Ri Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 553 Kingstown Rd, Wakefield, RI 02879 Phone: 401-304-9111 Fax: 401-284-0625 | |
John Jefferys Bandola, M.d. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 70 Kenyon Ave, Suite 326, Wakefield, RI 02879 Phone: 401-789-8543 Fax: 401-782-8766 | |
Evolvemd, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 155 Main St, Wakefield, RI 02879 Phone: 401-782-2400 |