Organization
RICHARD L GOODWIN O.D.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD L GOODWIN O.D. (PRESIDENT)
(207) 532-2486
Entity
Organization
Contact information
Practice address
75 MAIN ST, HOULTON, ME 04730-2122
(207) 532-2486
(207) 532-9242
Mailing address
75 MAIN ST, HOULTON, ME 04730-2122
(207) 532-2486
(207) 532-9242
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
611T
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
023153
BLUE CROSS
ME
05
—
117730099
—
ME
Enumeration date
01/22/2007
Last updated
11/08/2012
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