Individual
JOHN L FOGGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
593 EDDY ST, CLAVERICK 2, PROVIDENCE, RI 02903-4923
(401) 854-2504
(401) 854-2519
Mailing address
PO BOX 9484, PROVIDENCE, RI 02940-9484
(401) 854-2500
(401) 854-2519
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD12121
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12/29/2008
TUFTS HEALTH PLAN
MA
05
—
2119871
—
MA
01
—
413496
BCBSRI
RI
05
—
7058592
—
RI
01
—
9/26/2006
NHPRI
RI
01
—
939025129
RI MEDICARE GROUP NUMBER
RI
01
—
NPI
1720027253
RI
Enumeration date
06/06/2006
Last updated
09/17/2013
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