Healthcare Provider Details

I. General information

NPI: 1740250265
Provider Name (Legal Business Name): PAUL K FRIEND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 S MAIN ST
WEST FRANKLIN NH
03235-1508
US

IV. Provider business mailing address

PO BOX 1327
LACONIA NH
03247-1327
US

V. Phone/Fax

Practice location:
  • Phone: 603-934-4259
  • Fax: 603-934-1219
Mailing address:
  • Phone: 603-524-3211
  • Fax: 603-527-7038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5877
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: