Organization
KENNETH MACOUL MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH L MACOUL MD (OWNER)
(978) 685-5366
Entity
Organization
Contact information
Practice address
280 HAVERHILL ST, LAWRENCE, MA 01840
(978) 685-5366
(978) 685-4867
Mailing address
280 HAVERHILL ST, LAWRENCE, MA 01840
(978) 685-5366
(978) 685-4867
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0020957
NEIGHBORHOOD HEALTH
—
01
—
15777
HARVARD
—
01
—
29711
FALLON
—
01
—
702380
TUFTS
—
05
—
9701231
—
MA
01
—
988756
NETWORK HEALTH
—
01
—
M88005
BCBS
—
Enumeration date
12/01/2006
Last updated
04/16/2009
Update your record
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