Healthcare Provider Details

I. General information

NPI: 1952360430
Provider Name (Legal Business Name): JAMES PETER KOREN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2006
Last Update Date: 10/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 HOSPITAL ROAD SPEARE SURGICAL SERVICES
PLYMOUTH NH
03264
US

IV. Provider business mailing address

P.O. BOX 706
PLYMOUTH NH
03264-0706
US

V. Phone/Fax

Practice location:
  • Phone: 603-536-5670
  • Fax: 603-536-1544
Mailing address:
  • Phone: 603-481-8757
  • Fax: 603-238-2163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD419656
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number13971
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: