Organization
SOUTHCOAST PHYSICIANS GROUP, INC.
Active
Other names
Southcoast Urgent Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY ZIZZO (DIRECTOR, CBO)
(508) 973-2044
Entity
Organization
Contact information
Practice address
208 MILL RD, FAIRHAVEN, MA 02719-5208
(855) 319-0518
Mailing address
200 MILL RD, SUITE 180, FAIRHAVEN, MA 02719-5252
(508) 973-2000
(508) 973-2001
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
208M00000X
Hospitalist Physician
—
—
261QU0200X
Urgent Care Clinic/Center
—
MA
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110072422A
—
MA
05
—
BM20689
—
RI
01
—
CD2506
RAILROAD MEDICARE
MA
01
—
DT1369
RAILROAD MEDICARE
RI
Enumeration date
06/10/2013
Last updated
06/08/2017
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