1851397293 NPI number — DR. HENRY H ATKINS MD

Table of content: DR. LOIS ANN DUTTON PH.D. (NPI 1508038571)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851397293 NPI number — DR. HENRY H ATKINS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ATKINS
Provider First Name:
HENRY
Provider Middle Name:
H
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1851397293
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/30/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3 OLD SLOOP LANE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BATH
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04530-2912
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-319-0415
Provider Business Mailing Address Fax Number:
207-888-9592

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
735 WILSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BREWER
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04412
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-945-5247
Provider Business Practice Location Address Fax Number:
207-990-1248
Provider Enumeration Date:
06/21/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  009174 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1042020 . This is a "AETNA HMO" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 5688247 . This is a "AETNA POS" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 080096277 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 275580099 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".




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