MEDICARE: DEBORAH A. FORD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	55661	MA

General Provider Information

NPI Number	:	1407940562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH A. FORD M.D.

Provider Business Mailing Address
First Line	:	748 PLEASANT ST
Second Line	:
City	:	PAXTON
State	:	MA
Zip	:	01612-1024
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	103 MILLBURY ST
Second Line	:
City	:	AUBURN
State	:	MA
Zip	:	01501-3205
Country	:	US
Telephone Number	:	508-721-4100
Fax Number	:	508-721-4124

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	08/16/2024

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