Healthcare Provider Details

I. General information

NPI: 1407915861
Provider Name (Legal Business Name): JOSEPH KINDALL HURD JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 MALL RD
BURLINGTON MA
01805-0003
US

IV. Provider business mailing address

18 EMERSON RD
WELLESLEY MA
02481-3419
US

V. Phone/Fax

Practice location:
  • Phone: 781-744-8495
  • Fax: 781-744-1099
Mailing address:
  • Phone: 781-235-5912
  • Fax: 781-235-9424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number28952
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: