Healthcare Provider Details

I. General information

NPI: 1386962819
Provider Name (Legal Business Name): TAD P LANAGAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2010
Last Update Date: 08/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 CRESCENT ST
PENACOOK NH
03303-1412
US

IV. Provider business mailing address

4 CRESCENT ST
PENACOOK NH
03303-1412
US

V. Phone/Fax

Practice location:
  • Phone: 603-753-4302
  • Fax: 603-753-6213
Mailing address:
  • Phone: 603-753-4302
  • Fax: 603-753-6213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberT-0677
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: