David W Dougan, OPTICIAN

Individual provider Active NPI Optician · Orange, MA

NPI 1154571925 · NPPES record last updated Sep 29, 2008

Key facts

NPI
1154571925
Entity type
Individual (NPI type 1)
Primary specialty
Optician 156FX1800X
License
MA4163 (MA)
Practice address
119 New Athol Rd
Orange, MA 01364-9603
Phone
(978) 249-9033
Fax
(978) 249-9020
NPI assigned
Sep 29, 2008
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MA4163MAMDOptician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X MA4163 MA Yes

Addresses

Primary practice location

119 New Athol Rd
Orange, MA 01364-9603

Mailing address

119 New Athol Rd
Orange, MA 01364-9603
Phone (978) 249-9033

Other providers in Orange, MA

All providers in Orange, MA · Optician in Massachusetts

Sources for this page

Verify at the official NPI Registry.