Healthcare Provider Details

I. General information

NPI: 1225012420
Provider Name (Legal Business Name): VIRGINIA L ALVORD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 10/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 OLD ETNA RD
LEBANON NH
03766
US

IV. Provider business mailing address

1 MEDICAL CENTER DR DH - FAMILY MEDICINE
LEBANON NH
03756-1000
US

V. Phone/Fax

Practice location:
  • Phone: 603-650-4000
  • Fax: 603-650-4190
Mailing address:
  • Phone: 603-650-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9974
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: