Healthcare Provider Details

I. General information

NPI: 1710055967
Provider Name (Legal Business Name): WALPOLE PEDIATRIC ASSOC., PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 PINE ST STE 103
NORFOLK MA
02056-1680
US

IV. Provider business mailing address

1350 MAIN ST
WALPOLE MA
02081-1718
US

V. Phone/Fax

Practice location:
  • Phone: 508-668-2200
  • Fax: 608-668-6539
Mailing address:
  • Phone: 508-668-2200
  • Fax: 608-668-6539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. ANDREW J ARRISON
Title or Position: TREASURER
Credential: M.D.
Phone: 508-668-2200