Individual
DR. CARL E GULLBRAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
63 MAIN ST STE B, BUXTON, ME 04093-6101
(207) 929-3007
(207) 929-3595
Mailing address
PO BOX 629, BAR MILLS, ME 04004-0629
(207) 929-3007
(207) 929-3007
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT 752
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
UX6716
MEDICARE PTAN
ME
Enumeration date
03/21/2007
Last updated
09/27/2021
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