Basic Information
Provider Information | |||||||||
NPI: | 1548372758 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | HUBBELL | ||||||||
FirstName: | FRANKLIN | ||||||||
MiddleName: | RUTLEDGE | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | DO | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 7 GREENWOOD AVE | ||||||||
Address2: |   | ||||||||
City: | CONWAY | ||||||||
State: | NH | ||||||||
PostalCode: | 038186130 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6034473500 | ||||||||
FaxNumber: | 6034475568 | ||||||||
Practice Location | |||||||||
Address1: | 7 GREENWOOD AVE | ||||||||
Address2: |   | ||||||||
City: | CONWAY | ||||||||
State: | NH | ||||||||
PostalCode: | 038186130 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6034473500 | ||||||||
FaxNumber: | 6034475568 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 09/01/2006 | ||||||||
LastUpdateDate: | 08/13/2020 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 08/13/2020 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 9534 | NH | N |   | Allopathic & Osteopathic Physicians | Emergency Medicine |   | 208D00000X | 9534 | NH | Y |   | Allopathic & Osteopathic Physicians | General Practice |   |
ID Information
ID | Type | State | Issuer | Description | 0408141Y0NH01 | 01 | NH | ANTHEM BCBS | OTHER | 30009449 | 05 | NH |   | MEDICAID | 312210 | 01 | NH | CIGNA | OTHER |