Lifespan Physician Group, Inc. is a
Internal Medicine based in Warren, Rhode Island. Lifespan Physician Group, Inc. is licensed to practice in * (Not Available) (license number ) and their current practice location is
639 Metacom Ave, Warren, Rhode Island. It can be reached at their office (for appointments etc.) via phone at
(401) 245-1500.
NPI number for Lifespan Physician Group, Inc. is 1629449210 and their current mailing address is 117 Ellenfield St, Suite 101, Providence, Rhode Island. Lifespan Physician Group, Inc.
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1629449210.
Healthcare Provider's Profile
| Full Name | Lifespan Physician Group, Inc. |
|---|
| Type | Facility |
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| Speciality | Internal Medicine |
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| Location | 639 Metacom Ave, Warren, Rhode Island |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1629449210
- Provider Enumeration Date: 10/08/2015
- Last Update Date: 04/20/2023
Medical Identifiers
Medical identifiers for Lifespan Physician Group, Inc. such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1629449210 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lifespan Physician Group, Inc. is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Lifespan Physician Group, Inc.
117 Ellenfield St, Suite 101,
Providence, RI 02905-4513
Ph: (401) 444-6779 | Lifespan Physician Group, Inc.
639 Metacom Ave,
Warren, RI 02885-2348
Ph: (401) 245-1500 |
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