Healthcare Provider Details

I. General information

NPI: 1932861358
Provider Name (Legal Business Name): CONCORD ORTHOPAEDICS PROFESSIONAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2021
Last Update Date: 10/13/2021
Certification Date: 09/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 OLD FREMONT ROAD
RAYMOND NH
03077
US

IV. Provider business mailing address

264 PLEASANT ST
CONCORD NH
03301-2551
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-3368
  • Fax: 603-717-7373
Mailing address:
  • Phone: 603-224-3368
  • Fax: 603-224-7815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA HEBERT
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 603-224-3368