Provider Demographics
NPI:1447291604
Name:BROKAW, FRANCES CAROLINE (MD, MS)
Entity type:Individual
Prefix:DR
First Name:FRANCES
Middle Name:CAROLINE
Last Name:BROKAW
Suffix:
Gender:F
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-1000
Mailing Address - Country:US
Mailing Address - Phone:603-653-9500
Mailing Address - Fax:603-650-0915
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-1000
Practice Address - Country:US
Practice Address - Phone:603-653-9500
Practice Address - Fax:603-650-0915
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH8152207R00000X
VT8013207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30003079Medicaid
VT1002762Medicaid
NHRE041702Medicare PIN
E12742Medicare UPIN
NHRE041701Medicare PIN