Healthcare Provider Details

I. General information

NPI: 1265460281
Provider Name (Legal Business Name): JON MICHAEL BRIAN VORE JR. DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 12/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 LIMBO LANE
AMHERST NH
03031-1735
US

IV. Provider business mailing address

PO BOX 3677
NASHUA NH
03061-3677
US

V. Phone/Fax

Practice location:
  • Phone: 603-673-5885
  • Fax: 603-672-7150
Mailing address:
  • Phone: 603-577-7900
  • Fax: 603-577-7972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number13135
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: