Provider Demographics
NPI:1144207978
Name:FORD, JOHN EDWARD JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:EDWARD
Last Name:FORD
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8 CLOVER LANE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WHITEFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03598-3054
Mailing Address - Country:US
Mailing Address - Phone:603-837-9005
Mailing Address - Fax:603-788-5027
Practice Address - Street 1:8 CLOVER LANE
Practice Address - Street 2:SUITE 1
Practice Address - City:WHITEFIELD
Practice Address - State:NH
Practice Address - Zip Code:03598-3054
Practice Address - Country:US
Practice Address - Phone:603-837-9005
Practice Address - Fax:603-788-5027
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NH10554207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30200249Medicaid
NHORE5246Medicaid
NHORE5246Medicaid
NH30200249Medicaid