Healthcare Provider Details

I. General information

NPI: 1366492258
Provider Name (Legal Business Name): RICHARD BRADLEY FERRELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 CLINTON ST
CONCORD NH
03301-2359
US

IV. Provider business mailing address

1 MEDICAL CENTER DRIVE DARTMOUTH HITCHCOCK - PSYCHIATRY
LEBANON NH
03756
US

V. Phone/Fax

Practice location:
  • Phone: 603-271-5804
  • Fax: 603-271-5395
Mailing address:
  • Phone: 603-650-6150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number5394
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number5394
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: