Provider Demographics
NPI:1073710075
Name:SUOZZI, JAMES CONNOLLY (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:CONNOLLY
Last Name:SUOZZI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:644 COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:WALPOLE
Mailing Address - State:NH
Mailing Address - Zip Code:03608-4919
Mailing Address - Country:US
Mailing Address - Phone:603-756-3338
Mailing Address - Fax:
Practice Address - Street 1:580 COURT STREET
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431
Practice Address - Country:US
Practice Address - Phone:603-354-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT046138207P00000X
NH14439207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD400001095Medicare PIN