Provider Demographics
NPI:1417965468
Name:MAXFIELD CLINIC PROFESSIONAL ASSOCIATION
Entity Type:Organization
Organization Name:MAXFIELD CLINIC PROFESSIONAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF BUSINESS
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:CAMPBELL
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:603-863-3434
Mailing Address - Street 1:48 BELKNAP AVENUE
Mailing Address - Street 2:MAXFIELD CLINIC
Mailing Address - City:NEWPORT
Mailing Address - State:NH
Mailing Address - Zip Code:03773
Mailing Address - Country:US
Mailing Address - Phone:603-863-3434
Mailing Address - Fax:603-863-1728
Practice Address - Street 1:48 BELKNAP AVENUE
Practice Address - Street 2:MAXFIELD CLINIC
Practice Address - City:NEWPORT
Practice Address - State:NH
Practice Address - Zip Code:03773
Practice Address - Country:US
Practice Address - Phone:603-863-3434
Practice Address - Fax:603-863-1728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Multi-Specialty
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3436OtherANTHEM
NH=========OtherCIGNA
NH3436Medicare ID - Type Unspecified