Moulton, Anthony Le Roy

Moulton, Anthony Le Roy is an sole proprietor health care provider with primary practice located at 1 Randall Sq Ste 414, Providence RI 02904-2709. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Moulton, Anthony Le Roy can be contacted via phone (401) 331-4175.

Contact Information

Primary practice address
1 Randall Sq Ste 414 Providence RI 02904-2709
Phone: (401) 331-4175
Fax: (401) 331-5718
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 079657 Rhode Island

Profile Details

NPI number 1689695736
LBN Legal business name Moulton, Anthony Le Roy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 22nd, 2006
Last updated Nov 27th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689695736 NPPES
Rhode Island MEDICAID 9020315

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