Healthcare Provider Details

I. General information

NPI: 1073727665
Provider Name (Legal Business Name): DARTMOUTH HITCHCOCK PSYCHIATRIC ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL CENTER DRIVE
LEBANON NH
03756-0001
US

IV. Provider business mailing address

1 MEDICAL CENTER DRIVE
LEBANON NH
03756-0001
US

V. Phone/Fax

Practice location:
  • Phone: 603-650-6176
  • Fax:
Mailing address:
  • Phone: 603-650-6176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number StateNH

VIII. Authorized Official

Name: MR. GERALD BEST
Title or Position: PFS MANAGER
Credential:
Phone: 603-650-6176