# FENTON FAMILY MEDICINE, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568623676
- **Authorized official:** DR. RANDALL C FENTON M.D. (PHYSICIAN)
- **Authorized official phone:** (603) 894-0063

## Contact information

- **Practice address:** 58 RANGE RD, STE. R-03, WINDHAM, NH 03087-2026
- **Practice address phone:** (603) 894-0063
- **Practice address fax:** (603) 894-9727
- **Mailing address:** 58 RANGE RD, STE. R-03, WINDHAM, NH 03087-2026
- **Mailing address phone:** (603) 894-0063
- **Mailing address fax:** (603) 894-9727

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 9962 | NH | Yes |

## Other

- **Enumeration date:** 06/20/2008
- **Last updated:** 06/20/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | M17882 | BCBS MASSACHUSETTS | — |