Provider Demographics
NPI:1710173216
Name:SEACOAST VASECTOMY SERVICES, PC
Entity Type:Organization
Organization Name:SEACOAST VASECTOMY SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:H
Authorized Official - Last Name:FERRELL
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:603-926-3100
Mailing Address - Street 1:1 PARK AVE
Mailing Address - Street 2:UNIT 6-1
Mailing Address - City:HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03842-2113
Mailing Address - Country:US
Mailing Address - Phone:603-926-3100
Mailing Address - Fax:
Practice Address - Street 1:1 PARK AVE
Practice Address - Street 2:UNIT 6-1
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842-2113
Practice Address - Country:US
Practice Address - Phone:603-926-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH6945208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty