Provider Demographics
NPI:1437169604
Name:RODD, CAREY RATHBONE (MD)
Entity Type:Individual
Prefix:DR
First Name:CAREY
Middle Name:RATHBONE
Last Name:RODD
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 337
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03221-0337
Mailing Address - Country:US
Mailing Address - Phone:603-938-2692
Mailing Address - Fax:
Practice Address - Street 1:325 DANIEL WEBSTER HWY
Practice Address - Street 2:
Practice Address - City:BOSCAWEN
Practice Address - State:NH
Practice Address - Zip Code:03303-2410
Practice Address - Country:US
Practice Address - Phone:603-796-2165
Practice Address - Fax:603-796-3267
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH6377207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30204370Medicaid
NH30204370Medicaid