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Organization

OCEAN STATE PRIMARY CARE CENTER OF COVENTRY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JONATHAN H. MARTIN MD (MANAGING PARTNER)
(401) 821-6800
Entity
Organization

Contact information

Practice address
982 TIOGUE AVE, COVENTRY, RI 02816-6116
(401) 821-6800
(401) 821-8513
Mailing address
982 TIOGUE AVE, COVENTRY, RI 02816-6116
(401) 821-6800
(401) 821-8513

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner
363LA2200X
Adult Health Nurse Practitioner

Other

Enumeration date
04/06/2015
Last updated
10/11/2017
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