Individual
DR. KENNETH L MACOUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
30171
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D13190
BCBS OF MA
—
Enumeration date
12/01/2006
Last updated
04/09/2008
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