1659782555 NPI number — BARTLETT CHIROPRACTIC PLLC

Table of content: E JAMES FOGEL JR. M.D. (NPI 1194895813)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659782555 NPI number — BARTLETT CHIROPRACTIC PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BARTLETT CHIROPRACTIC PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659782555
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/13/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
644 FRANKLIN PIERCE HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BARRINGTON
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03825-7397
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-664-6724
Provider Business Mailing Address Fax Number:
603-664-6726

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
644 FRANKLIN PIERCE HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BARRINGTON
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03825-7397
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-664-6724
Provider Business Practice Location Address Fax Number:
603-664-6726
Provider Enumeration Date:
05/13/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BARTLETT
Authorized Official First Name:
TYLER
Authorized Official Middle Name:
GORDON
Authorized Official Title or Position:
DOCTOR OF CLINIC
Authorized Official Telephone Number:
603-343-8565

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  868-0510 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 868-0510 . This is a "STATE OF NH LICENSE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".