Provider Demographics
NPI:1659354488
Name:JAGMINAS, LIUDVIKAS J (MD)
Entity type:Individual
Prefix:
First Name:LIUDVIKAS
Middle Name:J
Last Name:JAGMINAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 PARK ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-3137
Mailing Address - Country:US
Mailing Address - Phone:508-222-5200
Mailing Address - Fax:508-236-7043
Practice Address - Street 1:211 PARK ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-3137
Practice Address - Country:US
Practice Address - Phone:508-222-5200
Practice Address - Fax:508-236-7043
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD08026207P00000X
MA219583207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7002104Medicaid
MA110059842AMedicaid