LIFESPAN PHYSICIAN GROUP INC. NPI 1407116643

NPI Information

  • NPI: 1407116643
  • Provider Name: LIFESPAN PHYSICIAN GROUP, INC.
  • Classification: General Practice - 208D00000X
  • Entity Type: Organization
  • :
  • Address: 593 EDDY ST
    PROVIDENCE, RI
    ZIP 02903
  • Phone: (401) 444-6779

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NPI Details

LIFESPAN PHYSICIAN GROUP, INC. is a general practice in Providence, RI. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee LIFESPAN PHYSICIAN GROUP, INC. NPI is 1407116643. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

593 EDDY ST
PROVIDENCE, RI
ZIP 02903-923
Phone: (401) 444-6779
Fax: (401) 444-6912

The provider's authorized official is Peter K Markell .
The authorized official title is Evp & Cfo and has the following contact phone number (401) 444-7914.

The enumeration date for this NPI number is 5/22/2012 and was last updated on 10/7/2025.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208600000XSurgeryNo
22086S0102XSurgerySurgical Critical CareNo
3133V00000XDietitian, RegisteredNo
4208C00000XColon & Rectal SurgeryNo
52086S0129XSurgeryVascular SurgeryNo
6152W00000XOptometristNo
72086S0127XSurgeryTrauma SurgeryNo
8207V00000XObstetrics & GynecologyNo
9204F00000XTransplant SurgeryNo
10208200000XPlastic SurgeryNo
112086X0206XSurgerySurgical OncologyNo
12208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)No
132086S0120XSurgeryPediatric SurgeryNo
14207LC0200XAnesthesiologyCritical Care MedicineNo
15208D00000XGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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