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Organization
EYECARE MEDICAL GROUP
Active
Organization
EYECARE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN SHORTY RN, CMPE (CHIEF OPERATING OFFICER)
(207) 791-8234
Entity
Organization
Contact information
Practice address
53 SEWALL STREET, PORTLAND, ME 04102
(207) 828-2020
(207) 773-7034
Mailing address
53 SEWALL ST, PORTLAND, ME 04102-2625
(207) 828-2020
(207) 773-7034
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
NULL
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109280200
—
ME
Enumeration date
09/14/2006
Last updated
12/30/2025
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