Provider Demographics
NPI:1972672814
Name:PACHECO, JAMES (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:PACHECO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 HOBBS ST
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03818-8109
Mailing Address - Country:US
Mailing Address - Phone:603-624-4366
Mailing Address - Fax:
Practice Address - Street 1:71 HOBBS ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03818-8109
Practice Address - Country:US
Practice Address - Phone:603-624-4366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA155553207P00000X, 207Q00000X
NH10690207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30221582Medicaid
NHP00776072OtherRAILROAD MCARE THRU SEACOAST
ME434577199Medicaid
NH30221582Medicaid
NHA2908402Medicare PIN