Organization
NORTHERN EYE CARE P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT HAINES NICHOLSON M D (PRESIDENT)
(207) 474-8850
Entity
Organization
Contact information
Practice address
56 MAIN ST, SKOWHEGAN, ME 04976-1146
(207) 474-8850
(207) 474-7372
Mailing address
PO BOX 66, SKOWHEGAN, ME 04976-0066
(207) 474-8850
(207) 474-7372
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
007644
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111690000
—
ME
Enumeration date
05/13/2008
Last updated
05/13/2008
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