Provider Demographics
NPI:1043246218
Name:STEGEN, RICHARD G (OD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:G
Last Name:STEGEN
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:10 BENNING ST
Mailing Address - Street 2:STE 10
Mailing Address - City:WEST LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03784-3402
Mailing Address - Country:US
Mailing Address - Phone:603-678-4759
Mailing Address - Fax:603-790-8047
Practice Address - Street 1:200 S MAIN ST
Practice Address - Street 2:SUITE 11
Practice Address - City:WEST LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03784-2014
Practice Address - Country:US
Practice Address - Phone:603-298-8064
Practice Address - Fax:603-298-7898
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2019-09-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH0592152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH271805OtherCIGNA
NH30009953Medicaid
NH0908753Y0NH01OtherANTHEM
NH271805OtherCIGNA
NH30009953Medicaid