Organization · Type 2 NPI

Lifespan Physician Group, Inc.

General Practice Physician · Providence, RI

NPI number 1407116643 Active

Practice location

593 Eddy St
Providence, RI 02903-4923

Call (401) 444-6779 Map

Fax (401) 444-6912

Mailing address

117 Ellenfield St, Suite 101
Providence, RI 02905-4513

Specialties and licenses

TaxonomyCodeLicense
Registered Dietitian 133V00000XNone listed
Optometrist 152W00000XNone listed
Transplant Surgery Physician 204F00000XNone listed
Critical Care Medicine (Anesthesiology) Physician 207LC0200XNone listed
Obstetrics & Gynecology Physician 207V00000XNone listed
Plastic Surgery Physician 208200000XNone listed
Surgery Physician 208600000XNone listed
Surgical Critical Care Physician 2086S0102XNone listed
Pediatric Surgery Physician 2086S0120XNone listed
Trauma Surgery Physician 2086S0127XNone listed
Vascular Surgery Physician 2086S0129XNone listed
Surgical Oncology Physician 2086X0206XNone listed
Colon & Rectal Surgery Physician 208C00000XNone listed
General Practice Physician Primary 208D00000XNone listed
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000XNone listed

General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

2,340 other providers at this address

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About NPI 1407116643

Lifespan Physician Group, Inc.'s National Provider Identifier is 1407116643, issued on May 22, 2012. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Providence, RI. The record was last updated on Oct 7, 2025.