Provider Demographics
NPI:1275594814
Name:ANNIS, JOSEPH PAYNE (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:PAYNE
Last Name:ANNIS
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 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-1000
Mailing Address - Country:US
Mailing Address - Phone:603-650-6177
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:DEPT. OF ANESTH., DHMC
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-1000
Practice Address - Country:US
Practice Address - Phone:603-650-6177
Practice Address - Fax:603-650-8980
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11862207L00000X
TXF2156207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP082X3602Medicaid
VT1009092Medicaid
NH30203109Medicaid
NHHX2756Medicare PIN
TXP082X3602Medicaid
VT1009092Medicaid