Individual
DR. EVERETT M BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
590 COURT ST, KEENE, NH 03431-1719
(603) 354-6534
Mailing address
590 COURT ST, KEENE, NH 03431-1719
(603) 354-6534
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
042.0014786
VT
207P00000X
Emergency Medicine Physician
Primary
20544
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3040982
MVP
VT
05
—
3123907
—
NH
05
—
6704425
—
VT
01
—
9735609
CIGNA
VT
Enumeration date
05/03/2016
Last updated
08/18/2022
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