Healthcare Provider Details

I. General information

NPI: 1629148911
Provider Name (Legal Business Name): PHENTON TRAVIS HARKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 NEW HAMPSHIRE AVE SUITE 100
PORTSMOUTH NH
03801
US

IV. Provider business mailing address

25 NEW HAMPSHIRE AVE SUITE 100
PORTSMOUTH NH
03801
US

V. Phone/Fax

Practice location:
  • Phone: 603-431-2516
  • Fax: 603-228-7307
Mailing address:
  • Phone: 603-431-2516
  • Fax: 603-228-7307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number13320
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number13320
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: