Provider Demographics
NPI:1780769315
Name:RODNEY A FELGATE MD
Entity type:Organization
Organization Name:RODNEY A FELGATE MD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:FELGATE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-745-8136
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NH
Mailing Address - Zip Code:03251-0129
Mailing Address - Country:US
Mailing Address - Phone:603-745-8136
Mailing Address - Fax:603-745-8138
Practice Address - Street 1:115 MAIN ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NH
Practice Address - Zip Code:03251-0129
Practice Address - Country:US
Practice Address - Phone:603-745-8136
Practice Address - Fax:603-745-8138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH4979207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30211880Medicaid
NH82083860Medicaid
NH1801980453OtherNPI FOR RODNEY A FELGATE
NHRE3176Medicare ID - Type UnspecifiedGROUP # FOR PRACTICE
NH30211880Medicaid
NHB85872Medicare UPIN