Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | NH7800 | NH |
NPI | 1285641134 |
---|---|
Provider Name | Dr. John Henry Spicer |
First Address | Littleton, NH 03561-5224 |
Second Address | Littleton, NH 03561-3437 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003822 | (05) | VT |
B86228 | (02) | NH |
GROUP #SPIC00003454 | INDIVIDUAL # 0003454 (01) | VT |