Provider Demographics
NPI:1033124623
Name:TOWN OF NORTH ANDOVER
Entity type:Organization
Organization Name:TOWN OF NORTH ANDOVER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MACMILLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-686-7834
Mailing Address - Street 1:1600 OSGOOD ST
Mailing Address - Street 2:SUITE 2035
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-1048
Mailing Address - Country:US
Mailing Address - Phone:978-688-9540
Mailing Address - Fax:
Practice Address - Street 1:1600 OSGOOD ST
Practice Address - Street 2:SUITE 2035
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-1048
Practice Address - Country:US
Practice Address - Phone:978-688-9540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y11023Medicare PIN