Healthcare Provider Details

I. General information

NPI: 1851710669
Provider Name (Legal Business Name): JOSEPH LAURENCE THOUIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2014
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3311 RIVERBEND DR
SPRINGFIELD OR
97477-8800
US

IV. Provider business mailing address

1 BOSTON MEDICAL CENTER PLACE
BOSTON MA
02118-2999
US

V. Phone/Fax

Practice location:
  • Phone: 541-484-4332
  • Fax: 541-242-6770
Mailing address:
  • Phone: 617-638-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD205227
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: