Healthcare Provider Details

I. General information

NPI: 1518051382
Provider Name (Legal Business Name): JOHN M. O'DAY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 03/18/2009
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 TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207YS0012X
TaxonomySleep Medicine (Otolaryngology) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. JOYCE M O'DAY
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 603-692-4500