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General NPI Number Information
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NPI Number | 1174698385
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Entity Type | Organization
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Legal Business Name | LGH MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 295 VARNUM AVE
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City | LOWELL
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State | MA
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Zip | 01854-2134
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Country | US
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Telephone | 978-788-7218
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Fax | 978-937-6850
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Provider Business Mailing Address
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Address Line | 295 VARNUM AVE
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City | LOWELL
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State | MA
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Zip | 01854-2134
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Country | US
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Telephone | 978-788-7218
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Fax | 978-937-6850
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Authorized Official
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Title or Position | DIRECTOR, PRACTICE OPERATIONS
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Name | MRS. SANDRA LEIGH
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Credential |
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Telephone | 978-788-7416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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