Individual provider · NPI-1

Dr. Jay Bryan Bannister, MD

Family Medicine · Concord, NH

NPI number1619970746
StatusActive
Last updated in NPPESMay 5, 2011

Details

NPI
1619970746
Entity type
Individual (NPI-1)
Name
Dr. Jay Bryan Bannister
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
May 23, 2005
Last updated
May 5, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine11361NHYes

Practice location

250 Pleasant St
Fhc Concord, Yeaple Building
Concord, NH 03301-7539

Phone 603-228-7200 · Fax 603-228-7307

Mailing address

250 Pleasant St
Fhc Concord, Yeaple Building
Concord, NH 03301-7539

Phone 603-228-7200 · Fax 603-228-7307

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