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General NPI Number Information
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NPI Number | 1508010703
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Entity Type | Organization
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Legal Business Name | OCEAN STATE PODIATRY & ASSOCIATES, LLC
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Dates
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Enumeration Date | 11/14/2008
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Last Update Date | 11/14/2008
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Provider Practice Location Address
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Address Line | 1410 WARWICK AVE
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City | WARWICK
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State | RI
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Zip | 02888-5068
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Country | US
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Telephone | 401-723-5461
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Fax | 401-723-9630
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Provider Business Mailing Address
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Address Line | 1410 WARWICK AVE
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City | WARWICK
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State | RI
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Zip | 02888-5068
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Country | US
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Telephone | 401-723-5461
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Fax | 401-723-9630
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Authorized Official
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Title or Position | MANAGER
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Name | DR. WILLIAM S NAUGHTON
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Credential | DPM
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Telephone | 401-723-5461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | DPM00321
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License Number State | RI
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