Healthcare Provider Details

I. General information

NPI: 1457315426
Provider Name (Legal Business Name): JAMES ALAN BETTI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 01/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 OLD ROLLINSFORD RD
DOVER NH
03820-2833
US

IV. Provider business mailing address

218 WALLIS RD
RYE NH
03870-2248
US

V. Phone/Fax

Practice location:
  • Phone: 603-742-5011
  • Fax: 603-742-3530
Mailing address:
  • Phone: 603-433-6569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number8379
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number8379
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: