Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 152W00000X | Optometrist | 227 | NH |
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 227 | NH |
NPI | 1003877028 |
---|---|
Provider Name | Dr. Richard D. Brannen |
First Address | Hanover, NH 03755-1219 |
Second Address | Hanover, NH 03755-1219 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2006 |
Last Update Date | 11/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0907766YONH01 | ANTHEM (01) | |
151239 | HARVARD PILGRIM (01) | |
2946 | NH CIGNA (01) | NH |
7766 | VT BC/BS (01) | VT |
T25678 | (02) | NH |