Provider Demographics
NPI:1629148911
Name:HARKER, PHENTON TRAVIS (MD)
Entity type:Individual
Prefix:
First Name:PHENTON
Middle Name:TRAVIS
Last Name:HARKER
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 1:25 NEW HAMPSHIRE AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801
Mailing Address - Country:US
Mailing Address - Phone:603-431-2516
Mailing Address - Fax:603-228-7307
Practice Address - Street 1:25 NEW HAMPSHIRE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801
Practice Address - Country:US
Practice Address - Phone:603-431-2516
Practice Address - Fax:603-228-7307
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH133202083P0901X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH222594672OtherUNITED HEALTHCARE INS
NH222594672OtherGREATWEST HEALTHCARE INS.
NH4491080OtherCIGNA INSURANCE
NH01YP11322NH01OtherANTHEM INSURANCE
NH4152065OtherMVP INSURANCE
NH3375424OtherAETNA INSURANCE
NH222594672OtherTRICARE INSURANCE
NH30206388Medicaid
NH222594672OtherMARTINS POINT INSURANCE
NH222594672OtherPRIVATE HEALTHCARE
NHAA75724OtherHARVARD PILGRIM INSURANCE