Provider Demographics
NPI:1174698419
Name:SIEGART, WILLIAM R (DO)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:R
Last Name:SIEGART
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 LAFAYETTE RD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03842-2222
Mailing Address - Country:US
Mailing Address - Phone:603-926-0088
Mailing Address - Fax:603-926-2853
Practice Address - Street 1:5 ALUMNI DR
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-2128
Practice Address - Country:US
Practice Address - Phone:603-580-6793
Practice Address - Fax:603-580-7006
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2008-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH9436207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000042890OtherBMC HEALTHNET PLAN
MA0162108Medicaid
930114660OtherRAILROAD MEDICARE
AA17419OtherHARVARD PILGRIM
NH30221919Medicaid
NH0401088Y0NH01OtherANTHEM
NH299790099Medicaid
NH299790099Medicaid
AA17419OtherHARVARD PILGRIM
MA0162108Medicaid