Individual
MRS. MARCY G SOUTHWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
60 COMMERCIAL ST, SUITE 404, CONCORD, NH 03301-5071
(603) 228-1763
(603) 228-7088
Mailing address
60 COMMERCIAL ST, SUITE 404, CONCORD, NH 03301-5071
(603) 228-1763
(603) 228-7088
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0391P
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30332153
—
NH
Enumeration date
06/21/2006
Last updated
12/14/2020
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