Theroux, Brian R

Theroux, Brian R is an individual health care provider with primary practice located at 1672 S County Trl Ste 101, E Greenwich RI 02818-5098. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Theroux, Brian R can be contacted via phone (401) 885-7546.

Contact Information

Primary practice address
1672 S County Trl Ste 101 E Greenwich RI 02818-5098
Fax: (401) 885-6658
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA00289 Rhode Island

Profile Details

NPI number 1275546277
LBN Legal business name Theroux, Brian R
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 14th, 2006
Last updated Jun 27th, 2012 - about 12 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 1275546277 NPPES
Rhode Island MEDICAID DE76182

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