Provider Demographics
NPI:1043270796
Name:HITCHMOTH, DOROTHY L (OD)
Entity Type:Individual
Prefix:DR
First Name:DOROTHY
Middle Name:L
Last Name:HITCHMOTH
Suffix:
Gender:F
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:PO BOX 302
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:NH
Mailing Address - Zip Code:03257-0302
Mailing Address - Country:US
Mailing Address - Phone:603-583-4211
Mailing Address - Fax:866-752-6802
Practice Address - Street 1:255 NEWPORT RD
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:NH
Practice Address - Zip Code:03257-5466
Practice Address - Country:US
Practice Address - Phone:603-583-4211
Practice Address - Fax:866-752-6802
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-26
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0652152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHU73613Medicare UPIN
NHRE 5093Medicare PIN