SOUTHBRIDGE OB GYN ASSOC NPI 1245393305

NPI Information

SOUTHBRIDGE OB GYN ASSOC is an obstetrics gynecology in Southbridge, MA. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. SOUTHBRIDGE OB GYN ASSOC NPI is 1245393305. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

100 SOUTH ST
STE G05
SOUTHBRIDGE, MA
ZIP 01550
Phone: (508) 765-5981

The provider's authorized official is Melissa Ann Johnson .
The authorized official title is Physician and has the following contact phone number (508) 765-5981.

The CLIA number assigned to this NPI record is 22D2201412 - school/student health service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/19/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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