Healthcare Provider Details

I. General information

NPI: 1912920513
Provider Name (Legal Business Name): JAMES P DEJOHN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 ROCHESTER HILL RD
ROCHESTER NH
03867-1728
US

IV. Provider business mailing address

163 ROCHESTER HILL RD
ROCHESTER NH
03867-1728
US

V. Phone/Fax

Practice location:
  • Phone: 603-332-0238
  • Fax: 603-332-7098
Mailing address:
  • Phone: 603-332-0238
  • Fax: 603-332-7098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number5475
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: