Provider Demographics
NPI:1114943651
Name:JOSPITRE, JOSEPH-MARIE LIONEL (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH-MARIE
Middle Name:LIONEL
Last Name:JOSPITRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:NH
Mailing Address - Zip Code:03570-2084
Mailing Address - Country:US
Mailing Address - Phone:603-752-3669
Mailing Address - Fax:603-752-3027
Practice Address - Street 1:133 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:NH
Practice Address - Zip Code:03570-2006
Practice Address - Country:US
Practice Address - Phone:603-752-2900
Practice Address - Fax:603-752-7797
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0162207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH2050870OtherCIGNA PROV #
NHAA73926OtherHARVARD PROV #
NH13249OtherNH LICENSE
NH30206287Medicaid
BJ9988986OtherDEA LICENSE
I64996Medicare UPIN
RE8876Medicare ID - Type Unspecified