1487733143 NPI number — TROY A NORTON OD, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487733143 NPI number — TROY A NORTON OD, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TROY A NORTON OD, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487733143
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/19/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 948
Provider Second Line Business Mailing Address:
112 NARROW GAUGE SQUARE
Provider Business Mailing Address City Name:
FARMINGTON
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04938-0948
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-778-6925
Provider Business Mailing Address Fax Number:
207-778-0578

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
112 NARROW GAUGE SQ
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FARMINGTON
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04938-5824
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-778-6925
Provider Business Practice Location Address Fax Number:
207-778-0578
Provider Enumeration Date:
11/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NORTON
Authorized Official First Name:
TROY
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OPTOMETRIST
Authorized Official Telephone Number:
207-778-6925

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  OPT837 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2437565 . This is a "AETNA" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 7782223 . This is a "VSP" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 039212 . This is a "BCBS" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: MN4001 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 039212 . This is a "ANTHEM BCBS" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 134280000 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4661 . This is a "DAVIS VISION" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: M187204 . This is a "CIGNA" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".




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