Individual
MR. WILLARD CARLETON CARPENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD/OPTOMETRIST
Contact information
Practice address
57 MAIN ST, NEWPORT, NH 03773-1519
(603) 863-7770
(603) 863-7248
Mailing address
PO BOX 148, NEWPORT, NH 03773-0148
(603) 863-7770
(603) 863-7248
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0222
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0907770Y0NH01
BLUE CROSS/BLUE SHIELD
NH
01
—
1052
DAVIS VISION
NH
01
—
355970
CIGNA
NH
01
—
4149509
MVP
NH
01
—
43913
SPECTERA
NH
05
—
80587770
—
NH
01
—
NH0222
EYEMED
NH
Enumeration date
07/17/2006
Last updated
10/28/2009
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