| Coastal Foot & Ankle Inc | |
|
850 Aquidneck Ave, Middletown, RI 02842-7280 | |
| (401) 849-2157 | |
| (401) 848-8441 |
| Full Name | Coastal Foot & Ankle Inc |
|---|---|
| Type | Facility |
| Speciality | Podiatrist - Foot & Ankle Surgery |
| Location | 850 Aquidneck Ave, Middletown, Rhode Island |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275052755 | NPI | - | NPPES |
| FH00185 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | DPM00316 (Rhode Island) | Primary |
| 261QM2500X | Clinic/center - Medical Specialty | 2210 (Massachusetts) | Secondary |
| Provider Name | Jonathan G Sabourin |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1306809603 PECOS PAC ID: 0941270144 Enrollment ID: I20040727000441 |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Foot & Ankle Inc 850 Aquidneck Ave, Middletown, RI 02842-7280 Ph: (401) 849-2157 | Coastal Foot & Ankle Inc 850 Aquidneck Ave, Middletown, RI 02842-7280 Ph: (401) 849-2157 |
Jonathan G Sabourin, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 850 Aquidneck Ave Ste 15, Middletown, RI 02842 Phone: 401-849-2157 Fax: 401-848-8441 | |
Douglas Alan Reid, DPM Podiatrist Medicare: Medicare Enrolled Practice Location: 850 Aquidneck Ave, Box 15, Middletown, RI 02842 Phone: 401-849-2157 Fax: 401-848-8441 |