Organization
LIFESPAN PHYSICIAN GROUP, INC.
Active
Parent organization
LIFESPAN CORPORATION
Other names
Brown Health Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFESPAN CORPORATION
Authorized official
MR. PETER K MARKELL (EVP & CFO)
(401) 444-7914
Entity
Organization
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-6779
(401) 444-6912
Mailing address
117 ELLENFIELD ST, SUITE 101, PROVIDENCE, RI 02905-4513
(401) 444-6779
(401) 444-6912
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
152W00000X
Optometrist
—
—
204F00000X
Transplant Surgery Physician
—
—
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208200000X
Plastic Surgery Physician
—
—
208600000X
Surgery Physician
—
—
2086S0102X
Surgical Critical Care Physician
—
—
2086S0120X
Pediatric Surgery Physician
—
—
2086S0127X
Trauma Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
2086X0206X
Surgical Oncology Physician
—
—
208C00000X
Colon & Rectal Surgery Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Enumeration date
05/22/2012
Last updated
10/07/2025
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