Healthcare Provider Details

I. General information

NPI: 1568761716
Provider Name (Legal Business Name): JEAN TOUCHAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2011
Last Update Date: 12/11/2020
Certification Date: 12/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 CORPORATE DR STE 200
PORTSMOUTH NH
03801-2847
US

IV. Provider business mailing address

789 CENTRAL AVE
DOVER NH
03820-2526
US

V. Phone/Fax

Practice location:
  • Phone: 603-610-8070
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number18827
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: