MEDICARE: MR. BARRY CHRISTOPHER CUSSON PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	0244P	NH
2	207X00000X	Orthopaedic Surgery Physician	PA460	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174587406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BARRY CHRISTOPHER CUSSON PA

Provider Business Mailing Address
First Line	:	1900 LAFAYETTE RD
Second Line	:	SUITE A
City	:	PORTSMOUTH
State	:	NH
Zip	:	03801-5679
Country	:	US
Telephone Number	:	603-431-1121
Fax Number	:	603-431-9147

Provider Business Practice Location Address
First Line	:	1900 LAFAYETTE RD
Second Line	:	SUITE A
City	:	PORTSMOUTH
State	:	NH
Zip	:	03801-5679
Country	:	US
Telephone Number	:	603-431-1121
Fax Number	:	603-431-9147

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2006
Last Update Date	:	02/23/2017

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