Provider Demographics
NPI:1427070630
Name:IRWIN, BRIAN R (DO)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:R
Last Name:IRWIN
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 234
Mailing Address - Street 2:TAMWORTH FAMILY MEDICINE
Mailing Address - City:WEST OSSIPEE
Mailing Address - State:NH
Mailing Address - Zip Code:03890-0234
Mailing Address - Country:US
Mailing Address - Phone:603-323-3311
Mailing Address - Fax:603-323-9305
Practice Address - Street 1:577 WHITE MOUNTAIN HIGHWAY
Practice Address - Street 2:
Practice Address - City:TAMWORTH
Practice Address - State:NH
Practice Address - Zip Code:03886-4631
Practice Address - Country:US
Practice Address - Phone:603-323-3311
Practice Address - Fax:603-323-9305
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH12236207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3022934Medicaid