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Contact Information

PAUL R BOURGUIGNON, MD
50 FAIR HARBOUR PL
SUITE 2C
NEW LONDON, CT06320-4731
 Phone: 860-443-3147
 Fax: 860-443-0087
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Vascular Surgery

2086S0129X 76 Physician/Peripheral Vascular Disease
Indicates primary specialty

NPI Profile & details for PAUL R BOURGUIGNON · (Male)

NPI Number 1154372175
Status Active
Credentials MD
Entity Individual
Enumeration date 05/15/2006
Last updated 05/08/2009 - About 17 years ago
Sole proprietor 1 No
Identifiers
  • CT License # 038703
  • CT Medicaid 001387035
  • Other 2V8005 HEALTHNET
  • CT Other 010038703CT03 ANTHEM
  • CT Other 9636760 CIGNA
  • CT Other 038703 CONNECTICARE
  • CT Other P3418275 OXFORD
Hospital affiliation(s)
  • LAWRENCE & MEMORIAL HOSPITAL - (Acute Care)
    365 MONTAUK AVE
    NEW LONDON, CT 06320
  • WESTERLY HOSPITAL - (Acute Care)
    25 WELLS STREET
    WESTERLY, RI 02891
  • YALE-NEW HAVEN HOSPITAL - (Acute Care)
    20 YORK ST
    NEW HAVEN, CT 06504
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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