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Organization

DERRY MEDICAL CENTER, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TONYA LYN WILSON (BILLING/CREDENTIALING MANAGER)
(603) 537-1317
Entity
Organization

Contact information

Practice address
6 TSIENNETO RD, SUITE 100, DERRY, NH 03038-1584
(603) 537-1300
(603) 537-1326
Mailing address
14B TSIENNETO RD, DERRY, NH 03038-1560
(603) 537-1300

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
207LP2900X
Pain Medicine (Anesthesiology) Physician
207Q00000X
Family Medicine Physician
Primary
207QS0010X
Sports Medicine (Family Medicine) Physician
207RN0300X
Nephrology Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
709488
TUFTS
NH
05
83019373
NH
Enumeration date
07/07/2006
Last updated
04/15/2026
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