=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194030395
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DARTMOUTH HITCHCOCK PSYCHIATRIC ASSOCIATES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/11/2010
-----------------------------------------------------
Last Update Date | 08/11/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 MEDICAL CENTER DR 5D
-----------------------------------------------------
City | LEBANON
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03756-1000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-650-8741
-----------------------------------------------------
Fax | 603-650-9442
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 MEDICAL CENTER DR 5D
-----------------------------------------------------
City | LEBANON
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03756-1000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VICE CHAIR OF CLINICAL SERVICES
-----------------------------------------------------
Name | DR. WILLIAM TORREY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 603-650-5857
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282N00000X
-----------------------------------------------------
Taxonomy Name | General Acute Care Hospital
-----------------------------------------------------
License Number | 1372
-----------------------------------------------------
License Number State | NH
-----------------------------------------------------