Organization
PARK SURGICAL ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER J COREY MD (PRESIDENT PHYSICIAN)
(508) 584-4104
Entity
Organization
Contact information
Practice address
1 PEARL STREET, STE 2700, BROCKTON, MA 02301-2870
(508) 584-4104
(508) 584-4105
Mailing address
1 PEARL STREET, STE 2700, BROCKTON, MA 02301-2870
(508) 584-4104
(508) 584-4106
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007011
NEIGHBORHOOD HEALTH PLAN
MA
01
—
600325
SECURE HORIZONS
MA
05
—
9704043
—
MA
01
—
97320
AETNA
MA
01
—
DB2012
RR MEDICARE
MA
Enumeration date
04/11/2006
Last updated
10/25/2007
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