Provider Demographics
NPI:1518976083
Name:HANSFORD, JOEL (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:HANSFORD
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 1:11 LONG HILL RD
Mailing Address - Street 2:
Mailing Address - City:STRATHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03885-2274
Mailing Address - Country:US
Mailing Address - Phone:603-205-6019
Mailing Address - Fax:
Practice Address - Street 1:11 LONG HILL RD
Practice Address - Street 2:
Practice Address - City:STRATHAM
Practice Address - State:NH
Practice Address - Zip Code:03885-2274
Practice Address - Country:US
Practice Address - Phone:603-205-6019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD14961207P00000X
NH10391207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
6010955OtherMVP
NH30201084Medicaid
930100692OtherRAILROAD MEDICARE
NH0106189Y0NH01OtherANTHEM
ME320810099Medicaid
MA0112810Medicaid
6010955OtherMVP
NHE49908Medicare UPIN