Individual
DR. JACK CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 SHATTUCK WAY STE 6, NEWINGTON, NH 03801-7876
(617) 372-4018
Mailing address
101 SHATTUCK WAY STE 6, NEWINGTON, NH 03801-7876
(617) 372-4018
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
34672
NH
Other
Enumeration date
03/26/2020
Last updated
10/15/2025
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