Provider Demographics
NPI:1770757692
Name:WILT, RAY EARL III (DO)
Entity type:Individual
Prefix:DR
First Name:RAY
Middle Name:EARL
Last Name:WILT
Suffix:III
Gender:M
Credentials:DO
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Mailing Address - Street 1:23 PLUMER RD UNIT 23
Mailing Address - Street 2:UNIT 12
Mailing Address - City:EPPING
Mailing Address - State:NH
Mailing Address - Zip Code:03042-1713
Mailing Address - Country:US
Mailing Address - Phone:603-734-2567
Mailing Address - Fax:
Practice Address - Street 1:426 CALEF HIGHWAY
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:NH
Practice Address - Zip Code:03825
Practice Address - Country:US
Practice Address - Phone:603-664-9003
Practice Address - Fax:603-664-0133
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2010-11-24
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Provider Licenses
StateLicense IDTaxonomies
NH15010207Q00000X
PAOS014529207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine