Organization
LAKEVILLE FAMILY MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT JAMES GAGNON MD (PRESIDENT)
(508) 947-6666
Entity
Organization
Contact information
Practice address
5 PRECINCT ST, LAKEVILLE, MA 02347-1427
(508) 947-6666
Mailing address
5 PRECINCT ST, LAKEVILLE, MA 02347-1427
(508) 947-6666
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
81226
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M17688
MASS BLUE CROSS
MA
Enumeration date
06/11/2007
Last updated
10/12/2010
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