Healthcare Provider Details
I. General information
NPI: 1740656123
Provider Name (Legal Business Name): ACCESS SPORTS MEDICINE & ORTHOPAEDICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/19/2015
Last Update Date: 04/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13 PLAISTOW RD
PLAISTOW NH
03865-2838
US
IV. Provider business mailing address
1 HAMPTON RD SUITE 200
EXETER NH
03833-4848
US
V. Phone/Fax
- Phone: 603-382-1559
- Fax: 603-382-0088
- Phone: 603-775-7575
- Fax: 603-778-9680
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOSHUA
A
SIEGEL
Title or Position: PARTNER
Credential: MD
Phone: 603-775-7575