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General NPI Number Information
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NPI Number | 1033741517
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Entity Type | Organization
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Legal Business Name | CLEARCHOICEMD MSO, LLC
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Dates
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Enumeration Date | 02/12/2020
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Last Update Date | 07/22/2020
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Provider Practice Location Address
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Address Line | 127 PLAISTOW RD STE 1
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City | PLAISTOW
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State | NH
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Zip | 03865-2811
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Country | US
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Telephone | 603-797-9289
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Fax | 603-526-2151
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Provider Business Mailing Address
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Address Line | 74 PLEASANT ST STE 204
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City | NEW LONDON
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State | NH
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Zip | 03257-5881
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Country | US
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Telephone | 603-526-4635
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Fax | 603-526-2151
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. MARCUS J HAMPERS
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Credential | MD
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Telephone | 603-526-4635
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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