Organization
DARTMOUTH-HITCHCOCK CLINIC
Active
Organization
DARTMOUTH-HITCHCOCK CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL P. JANTZEN (CHIEF FINANCIAL OFFICER)
(603) 650-5668
Entity
Organization
Contact information
Practice address
ONE MEDICAL CENTER DR, LEBANON, NH 03756-0001
(603) 650-5000
Mailing address
PO BOX 419093, BOSTON, MA 02241-9093
(603) 650-5000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207P00000X
Emergency Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
208000000X
Pediatrics Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
208600000X
Surgery Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
02552
NH
261QD0000X
Dental Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009590
—
VT
05
—
3079670
—
NH
05
—
43700520
—
NH
01
—
CA0032
RAILROAD MEDICARE
NH
01
—
CB8692
RAILROAD MEDICARE
VT
Enumeration date
05/12/2006
Last updated
12/19/2018
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