Provider Demographics
NPI: | 1033162037 |
---|---|
Name: | FOUNDATION MEDICAL PARTNERS INC |
Entity Type: | Organization |
Organization Name: | FOUNDATION MEDICAL PARTNERS INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | INTERIM PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JAMES |
Authorized Official - Middle Name: | G |
Authorized Official - Last Name: | WATKINS |
Authorized Official - Suffix: | JR |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 603-281-8585 |
Mailing Address - Street 1: | PO BOX 3677 |
Mailing Address - Street 2: | |
Mailing Address - City: | NASHUA |
Mailing Address - State: | NH |
Mailing Address - Zip Code: | 03061-3677 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 603-577-7900 |
Mailing Address - Fax: | 603-577-5674 |
Practice Address - Street 1: | 8 PROSPECT ST |
Practice Address - Street 2: | |
Practice Address - City: | NASHUA |
Practice Address - State: | NH |
Practice Address - Zip Code: | 03060-3925 |
Practice Address - Country: | US |
Practice Address - Phone: | 603-281-8585 |
Practice Address - Fax: | 603-577-5674 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-05-18 |
Last Update Date: | 2022-10-28 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NH | 207N00000X, 207Q00000X, 207R00000X, 207RC0000X, 207RE0101X, 207RG0100X, 207RH0003X, 207RI0200X, 207RN0300X, 207RP1001X, 207RR0500X, 207T00000X, 207V00000X, 207X00000X, 208600000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | Group - Multi-Specialty | |
No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
No | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | Group - Multi-Specialty |
No | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Multi-Specialty |
No | 207RI0200X | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | Group - Multi-Specialty |
No | 207RN0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | Group - Multi-Specialty |
No | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | Group - Multi-Specialty |
No | 207RR0500X | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | Group - Multi-Specialty |
No | 207T00000X | Allopathic & Osteopathic Physicians | Neurological Surgery | Group - Multi-Specialty | |
No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NH | 80002724 | Medicaid | |
NH | 80002724 | Medicaid |