Provider Demographics
NPI:1891291183
Name:WDPC ORTHOPEDICS LLC
Entity Type:Organization
Organization Name:WDPC ORTHOPEDICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. REVENUE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAGNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-740-3205
Mailing Address - Street 1:PO BOX 23532
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4486
Mailing Address - Country:US
Mailing Address - Phone:603-740-4478
Mailing Address - Fax:
Practice Address - Street 1:7 MARSH BROOK DR
Practice Address - Street 2:
Practice Address - City:SOMERSWORTH
Practice Address - State:NH
Practice Address - Zip Code:03878
Practice Address - Country:US
Practice Address - Phone:603-742-2007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WENTWORTH DOUGLASS PHYSICIAN CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-04
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty