Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 15035 | NH |
N | 2080A0000X | Adolescent Medicine | 15035 | NH |
N | 2080A0000X | Adolescent Medicine | 35-084751 | OH |
NPI | 1144317140 |
---|---|
Provider Name | Dr. Keith J Loud |
First Address | Lebanon, NH 03756-1000 |
Second Address | Lebanon, NH 03756-1000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 21/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1018270 | (05) | VT |
2503553 | (05) | OH |
30209933 | (05) | NH |
I15306 | (02) |