Basic Information
Provider Information
NPI: 1366451338
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: INGERSOLL
FirstName: FRANCIS
MiddleName: W
NamePrefix:  
NameSuffix: III
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
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Mailing Information
Address1: 370 FAUNCE CORNER ROAD
Address2: SOUTHCOAST PHYSICIAN SERVICES INC
City: NO DARTMOUTH
State: MA
PostalCode: 02747
CountryCode: US
TelephoneNumber: 5089852000
FaxNumber: 5089852001
Practice Location
Address1: 101 PAGE STREET
Address2: SOUTHCOAST PHYSICIAN SERVICES INC
City: NEW BEDFORD
State: MA
PostalCode: 02740
CountryCode: US
TelephoneNumber: 5089615919
FaxNumber: 5089615916
Other Information
ProviderEnumerationDate: 08/07/2006
LastUpdateDate: 03/08/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X160595MAY Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000XDO00506RIN Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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