Healthcare Provider Details

I. General information

NPI: 1508880964
Provider Name (Legal Business Name): JOHN M O'DAY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 05/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

361 HIGH ST
SOMERSWORTH NH
03878-1407
US

IV. Provider business mailing address

361 HIGH ST
SOMERSWORTH NH
03878-1407
US

V. Phone/Fax

Practice location:
  • Phone: 603-692-4500
  • Fax: 603-692-4520
Mailing address:
  • Phone: 603-692-4500
  • Fax: 603-692-4520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number5507
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number5507
License Number StateNH
# 3
Primary TaxonomyN
Taxonomy Code207YS0012X
TaxonomySleep Medicine (Otolaryngology) Physician
License Number5507
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: