Healthcare Provider Details

I. General information

NPI: 1740409556
Provider Name (Legal Business Name): PARKLAND PHYSICIAN SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 12/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 TSIENNETO RD SUITE 204
DERRY NH
03038-1584
US

IV. Provider business mailing address

6 TSIENNETO RD SUITE 204
DERRY NH
03038-1584
US

V. Phone/Fax

Practice location:
  • Phone: 603-421-2526
  • Fax: 603-421-2526
Mailing address:
  • Phone: 603-421-2526
  • Fax: 603-421-2526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VH0002X
TaxonomyHospice and Palliative Medicine (Obstetrics & Gynecology) Physician
License Number
License Number State

VIII. Authorized Official

Name: KENNETH WASHINGTON
Title or Position: VP
Credential:
Phone: 703-650-2907