Organization
WILLOW STREET FAMILY PRACTICE INC
Active
Other names
Patton Park Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE W SMITH M.D. (OWNER)
(978) 468-4101
Entity
Organization
Contact information
Practice address
42 ASBURY ST, SOUTH HAMILTON, MA 01982-1808
(978) 468-4101
Mailing address
42 ASBURY ST, SOUTH HAMILTON, MA 01982-1808
(978) 468-4101
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
70411
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9738240
—
MA
01
—
M18879
BCBS GROUP PROVIDER NUMBE
MA
Enumeration date
01/02/2007
Last updated
07/29/2015
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