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Contact Information

LIFESPAN PHYSICIAN GROUP INC
593 EDDY STREET
PROVIDENCE, RI02903
 Phone: 401-444-7442
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Behavioral Neurology & Neuropsychiatry

2084B0040X
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Clinical

103TC0700X 62 Psychologist, Clinical
 

Clinical Child & Adolescent

103TC2200X 62 Psychologist, Clinical
 

Clinical Neurophysiology

2084N0600X 86 Physician/Neuropsychiatry
 

Clinical Neuropsychologist

103G00000X
 

Neurology

2084N0400X 13 Physician/Neurology
 

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
 

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for LIFESPAN PHYSICIAN GROUP INC

NPI # 1548506793
LBN Legal business name LIFESPAN PHYSICIAN GROUP INC
Authorized official PETER MARKELL - (EVP & CFO)
Entity Organization
Organization subpart 1 Yes
Enumeration date 12/17/2012
Last updated 04/03/2026 - About 2 months ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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