Provider Demographics
NPI:1386962819
Name:LANAGAN, TAD P (DO)
Entity type:Individual
Prefix:
First Name:TAD
Middle Name:P
Last Name:LANAGAN
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 1:4 CRESCENT ST
Mailing Address - Street 2:
Mailing Address - City:PENACOOK
Mailing Address - State:NH
Mailing Address - Zip Code:03303-1412
Mailing Address - Country:US
Mailing Address - Phone:603-753-4302
Mailing Address - Fax:603-753-6213
Practice Address - Street 1:4 CRESCENT ST
Practice Address - Street 2:
Practice Address - City:PENACOOK
Practice Address - State:NH
Practice Address - Zip Code:03303-1412
Practice Address - Country:US
Practice Address - Phone:603-753-4302
Practice Address - Fax:603-753-6213
Is Sole Proprietor?:No
Enumeration Date:2010-05-07
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHT-0677207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program