Provider Demographics
NPI:1215182076
Name:AFFILIATES IN PODIATRY PC
Entity Type:Organization
Organization Name:AFFILIATES IN PODIATRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:N
Authorized Official - Last Name:MCCANN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:603-225-5281
Mailing Address - Street 1:248 PLEASANT ST.
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301
Mailing Address - Country:US
Mailing Address - Phone:603-225-5281
Mailing Address - Fax:603-228-7095
Practice Address - Street 1:15 AIKEN AVENUE
Practice Address - Street 2:FRANKLIN REGIONAL HOSPITAL SPECIALTY CLINIC
Practice Address - City:FRANKLIN
Practice Address - State:NH
Practice Address - Zip Code:03235
Practice Address - Country:US
Practice Address - Phone:603-934-2060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AFFILIATES IN PODIATRY PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-20
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30003710Medicaid
T95775Medicare UPIN
NH30003710Medicaid
RE1165Medicare PIN