Provider Demographics
NPI:1033766647
Name:ENGELHART, KARL CAMERON (OD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:CAMERON
Last Name:ENGELHART
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 MANCHESTER ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5142
Mailing Address - Country:US
Mailing Address - Phone:603-226-0855
Mailing Address - Fax:603-226-0981
Practice Address - Street 1:153 MANCHESTER ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5142
Practice Address - Country:US
Practice Address - Phone:603-226-0855
Practice Address - Fax:603-226-0981
Is Sole Proprietor?:No
Enumeration Date:2019-08-20
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1002152W00000X
MEOPT1018152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist