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Individual

JOHN A DUBOIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
91 MAPLE ST, CORNISH, ME 04020-3101
(207) 625-3700
(207) 625-3277
Mailing address
PO BOX 18, CORNISH, ME 04020-0018
(207) 625-3700
(207) 625-3277

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
0698
NH
152W00000X
Optometrist
Primary
836TA
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100431
ANTHEM BCBS
ME
01
14373851
AETNA
ME
01
93222397
CIGNA
ME
Enumeration date
11/18/2005
Last updated
04/25/2016
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