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Individual

JON C OLDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
20 HARTFORD ST, HOULTON, ME 04730-1891
(207) 532-2900
(207) 532-5974
Mailing address
20 HARTFORD ST, HOULTON, ME 04730-1891
(207) 532-2900
(207) 532-5974

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO1652
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
323250099
ME
Enumeration date
03/14/2006
Last updated
05/04/2017
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