Individual
DR. REGINALD MAILHOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
220 SABATTUS ST, LEWISTON, ME 04240-6347
(207) 782-9501
Mailing address
220 SABATTUS ST, LEWISTON, ME 04240-6347
(207) 782-9501
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT602
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000023
ANTHEM ID #
ME
05
—
105560000
—
ME
01
—
M52420
CIGNA HEALTHSOURCE #
ME
Enumeration date
05/25/2006
Last updated
10/06/2009
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