Organization
BACKUS PHYSICIAN SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL LOHR (VICE PRESIDENT)
(860) 889-8331
Entity
Organization
Contact information
Practice address
12 CASE ST, SUITE 313, NORWICH, CT 06360-2222
(860) 204-9126
(860) 204-9146
Mailing address
112 LAFAYETTE ST, NORWICH, CT 06360-2737
(860) 425-8715
(860) 425-8707
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
208200000X
Plastic Surgery Physician
—
—
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
—
—
208600000X
Surgery Physician
—
—
208C00000X
Colon & Rectal Surgery Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
06/09/2008
Last updated
10/04/2012
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