| Brent Richardson, | |
|
240 S Main St, Wolfeboro, NH 03894-4411 | |
| (603) 569-7500 | |
| Not Available |
| Full Name | Brent Richardson |
|---|---|
| Gender | Male |
| Speciality | Surgery |
| Location | 240 S Main St, Wolfeboro, New Hampshire |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407241805 | NPI | - | NPPES |
| 3123567 | Medicaid | NH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 20505 (New Hampshire) | Primary |
| 208600000X | Surgery | TRN21762 (Florida) | Secondary |
| Entity Name | Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700864709 PECOS PAC ID: 2365418993 Enrollment ID: O20040907000095 |
| Mailing Address | Practice Location Address |
|---|---|
| Brent Richardson, 653 W 8th St, Jacksonville, FL 32209-6511 Ph: (904) 244-3903 | Brent Richardson, 240 S Main St, Wolfeboro, NH 03894-4411 Ph: (603) 569-7500 |
William B Barton, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 240 S Main St, Wolfeboro, NH 03894 Phone: 603-569-7511 Fax: 603-569-7512 | |
Erik Patrick Dutson, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 240 S Main St, Wolfeboro, NH 03894 Phone: 603-569-7511 Fax: 603-569-7512 | |
Thomas R Molano, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 240 S Main St, Wolfeboro General Surgery, Wolfeboro, NH 03894 Phone: 603-569-7511 Fax: 603-569-7512 | |
Dr. Peter Congelosi, Surgery Medicare: Accepting Medicare Assignments Practice Location: 240 S Main St, Wolfeboro, NH 03894 Phone: 603-569-7512 Fax: 603-569-7511 | |
Matthew S Jones, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 240 S Main St, Wolfeboro, NH 03894 Phone: 603-569-7511 Fax: 603-569-7512 |