Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 0101240554 | VA |
Y | 207QS0010X | Family Doctor - Sports Medicine | 14555 | NH |
NPI | 1073617429 |
---|---|
Provider Name | Emily Margaret Jones |
First Address | Concord, NH 03301-7560 |
Second Address | Concord, NH 03301-7560 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2006 |
Last Update Date | 03/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30209035 | (05) | NH |