Provider Demographics
NPI:1891962411
Name:EXETER HAMPTON DIAGNOSTICS, INC
Entity Type:Organization
Organization Name:EXETER HAMPTON DIAGNOSTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:WINDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-964-3392
Mailing Address - Street 1:65 LAFAYETTE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03862-2480
Mailing Address - Country:US
Mailing Address - Phone:603-964-3392
Mailing Address - Fax:603-964-3396
Practice Address - Street 1:65 LAFAYETTE RD
Practice Address - Street 2:
Practice Address - City:NORTH HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03862-2480
Practice Address - Country:US
Practice Address - Phone:603-964-3392
Practice Address - Fax:603-964-3396
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EXETER HAMPTON DIAGNOSTIC,INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-13
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH02815291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHNH8697Medicare PIN