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General NPI Number Information
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NPI Number | 1730891649
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Entity Type | Organization
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Legal Business Name | RIVERSIDE DOCS, PLLC
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Dates
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Enumeration Date | 12/22/2022
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Last Update Date | 12/22/2022
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Provider Practice Location Address
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Address Line | 262 SWANSEA MALL DR
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City | SWANSEA
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State | MA
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Zip | 02777-4121
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Country | US
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Telephone | 508-343-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 262 SWANSEA MALL DR
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City | SWANSEA
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State | MA
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Zip | 02777-4121
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Country | US
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Telephone | 508-343-8400
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | JOHN LITTLEFIELD
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Credential | MD
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Telephone | 508-343-8400
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine 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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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