Healthcare Provider Details

I. General information

NPI: 1811964778
Provider Name (Legal Business Name): GERALD ERNEST SAVARD O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 01/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 W GROVE ST SUITE 101
MIDDLEBORO MA
02346-1458
US

IV. Provider business mailing address

511 W GROVE ST SUITE 101
MIDDLEBORO MA
02346-1458
US

V. Phone/Fax

Practice location:
  • Phone: 508-947-7321
  • Fax: 508-947-0086
Mailing address:
  • Phone: 508-947-7321
  • Fax: 508-947-0086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2318
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: