Individual
JASON G. EMMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15 FREETOWN RD, RAYMOND, NH 03077-2358
(603) 895-8000
(603) 895-8099
Mailing address
15 FREETOWN RD, RAYMOND, NH 03077-2358
(603) 895-8000
(603) 895-8099
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
11692
NH
208000000X
Pediatrics Physician
11692
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011692
TUFTS PIN
NH
01
—
01YP03984NH01
ANTHEM ACES PIN
NH
01
—
0406992
UHC PIN
NH
01
—
110240392
RR MEDICARE PIN
NH
01
—
20309Y
ANTHEM REFERRING RAN
NH
01
—
2943621
AETNA PIN
NH
05
—
30203090
—
NH
01
—
3849838
CIGNA PIN
NH
01
—
692880
HPHC PIN
NH
Enumeration date
11/02/2005
Last updated
06/20/2008
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