Healthcare Provider Details

I. General information

NPI: 1295949782
Provider Name (Legal Business Name): JOEL PHILLIP HERRINGTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 04/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

243 ELM STREET
CLAREMONT NH
03743-2099
US

IV. Provider business mailing address

243 ELM STREET
CLAREMONT NH
03743-2099
US

V. Phone/Fax

Practice location:
  • Phone: 603-542-7771
  • Fax: 603-543-6950
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD19837
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: