=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851613681
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GEORGETOWN FAMILY MEDICINE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/21/2010
-----------------------------------------------------
Last Update Date | 02/08/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 256 GEORGETOWN RD SUITE #7
-----------------------------------------------------
City | BOXFORD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01921-1642
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-887-0222
-----------------------------------------------------
Fax | 978-887-2616
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 256 GEORGETOWN RD SUITE #7
-----------------------------------------------------
City | BOXFORD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01921-1642
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-887-0222
-----------------------------------------------------
Fax | 978-887-2616
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PRESIDENT/MANAGER
-----------------------------------------------------
Name | DR. LINDA MARIE HINDLE
-----------------------------------------------------
Credential | D.O.
-----------------------------------------------------
Telephone | 978-887-0222
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 236490
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------