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Contact Information

JACK CHAN, MD
101 SHATTUCK WAY STE 6
NEWINGTON, NH03801-7876
 Phone: 617-372-4018
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
Indicates primary specialty

NPI Profile & details for JACK CHAN · (Male)

NPI # 1376170522
Status Active
Credentials MD
Entity Individual
Enumeration date 03/26/2020
Last updated 10/15/2025 - About 8 months ago
Sole proprietor 1 Yes
Identifiers
  • NH License # 34672
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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