Provider Demographics
NPI:1033741517
Name:CLEARCHOICEMD MSO, LLC
Entity Type:Organization
Organization Name:CLEARCHOICEMD MSO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:J
Authorized Official - Last Name:HAMPERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-526-4635
Mailing Address - Street 1:74 PLEASANT ST STE 204
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:NH
Mailing Address - Zip Code:03257-5881
Mailing Address - Country:US
Mailing Address - Phone:603-526-4635
Mailing Address - Fax:603-526-2151
Practice Address - Street 1:127 PLAISTOW RD STE 1
Practice Address - Street 2:
Practice Address - City:PLAISTOW
Practice Address - State:NH
Practice Address - Zip Code:03865-2811
Practice Address - Country:US
Practice Address - Phone:603-797-9289
Practice Address - Fax:603-526-2151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-12
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care