Paul R. Moulton, M.D.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

012516 Issued in ME

Legal business name

PAUL R. MOULTON, M.D.

Practice address

5 Grove Street
Bangor, ME 04401-5394

Phone

(207) 945-3619

Fax

(207) 941-0817

NPI assigned

Mar 17, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Paul Rush Moulton, M.D.

Title

Owner

Phone

(207) 945-3619

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205712000000",
    "number": "1124299219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 GROVE STREET",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015394",
            "telephone_number": "207-945-3619",
            "fax_number": "207-941-0817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 GROVE STREET",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015394",
            "telephone_number": "207-945-3619",
            "fax_number": "207-941-0817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL R. MOULTON, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-17",
        "last_updated": "2008-03-17",
        "status": "A",
        "authorized_official_last_name": "MOULTON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "RUSH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-945-3619",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "ME",
            "license": "012516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mikaylah Payeur

• Eyewear Supplier in Bangor, ME
• Providers in Bangor, ME by specialty
• Eyewear Supplier in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.