Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 6130 | NH |
Y | 208600000X | Surgeon | 6130 | NH |
NPI | 1003873829 |
---|---|
Provider Name | Dr. John Paul Gens JR. |
First Address | Portsmouth, NH 03801-5711 |
Second Address | Portsmouth, NH 03801-7128 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 13/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3083000 | (05) | NH |
40200204 | (05) | NH |
D74994 | (02) | NH |
P01175889 | RAILROAD MEDICARE (01) | NH |