Provider Demographics
NPI:1801980453
Name:FELGATE, RODNEY ALAN (MD)
Entity type:Individual
Prefix:
First Name:RODNEY
Middle Name:ALAN
Last Name:FELGATE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 MAIN STREET
Mailing Address - Street 2:PO BOX 129
Mailing Address - City:LINCOLN
Mailing Address - State:NH
Mailing Address - Zip Code:03251
Mailing Address - Country:US
Mailing Address - Phone:603-745-8136
Mailing Address - Fax:603-745-8138
Practice Address - Street 1:115 MAIN STREET
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NH
Practice Address - Zip Code:03251
Practice Address - Country:US
Practice Address - Phone:603-745-8136
Practice Address - Fax:603-745-8138
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH4979207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30211880Medicaid
NH82083860Medicaid
NHB85872Medicare UPIN
NH30211880Medicaid
NH82083860Medicaid