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Individual
DR. RANDALL CLARK FENTON
Active
Individual
DR. RANDALL CLARK FENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9962
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0100419YPNH01
ANTHEM BCBS NEW HAMPSHIRE
—
01
—
2637002
AETNA
—
01
—
407866
UNIFORMED SERVICES FAMILY
—
01
—
66951
CIGNA
—
01
—
71838
HARVARD PILGRIM HEALTHCAR
—
01
—
753299
TUFTS HEALTHPLAN
—
01
—
J17896
BCBS OF MASSACHUSETTS
—
Enumeration date
07/15/2005
Last updated
02/08/2016
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