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Organization
SOUTHCOAST PHYSICIANS GROUP, INC.
Active
Organization
SOUTHCOAST PHYSICIANS GROUP, INC.
Active
Other names
Family MediCenter
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY ZIZZO (DIRECTOR, CBO)
(508) 973-2044
Entity
Organization
Contact information
Practice address
672 AQUIDNECK AVE, MIDDLETOWN, RI 02842-5795
(401) 847-0519
(401) 846-0283
Mailing address
200 MILL RD, SUITE 180, FAIRHAVEN, MA 02719-5252
(508) 973-2000
(508) 973-2001
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
01/07/2014
Last updated
01/07/2014
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