Provider Demographics
NPI:1356311336
Name:COOLIDGE, J DUNCAN (MD)
Entity Type:Individual
Prefix:
First Name:J
Middle Name:DUNCAN
Last Name:COOLIDGE
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:PO BOX 1327
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03247-1327
Mailing Address - Country:US
Mailing Address - Phone:603-524-3211
Mailing Address - Fax:603-527-7038
Practice Address - Street 1:15 AIKEN AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NH
Practice Address - Zip Code:03235-1259
Practice Address - Country:US
Practice Address - Phone:603-934-6562
Practice Address - Fax:603-934-4298
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH6416207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH9764704OtherCIGNA
NH468403OtherAETNA
NH383800OtherMVP
NH692981OtherHARVARD PILGRIM HLTHCARE
NH81110213Medicaid
NH9764704OtherCIGNA
NHB85851Medicare UPIN