Provider Demographics
NPI:1477738839
Name:JOHN F MINTEER OD PLLC
Entity Type:Organization
Organization Name:JOHN F MINTEER OD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:MINTEER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:603-924-9591
Mailing Address - Street 1:129 WILTON RD
Mailing Address - Street 2:
Mailing Address - City:PETERBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03458-1749
Mailing Address - Country:US
Mailing Address - Phone:603-924-9591
Mailing Address - Fax:603-924-9593
Practice Address - Street 1:129 WILTON RD
Practice Address - Street 2:
Practice Address - City:PETERBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03458-1749
Practice Address - Country:US
Practice Address - Phone:603-924-9591
Practice Address - Fax:603-924-9593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-04
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH282332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH80587783Medicaid
NHT25685Medicare UPIN
NH4956720001Medicare NSC
NHNH7783Medicare PIN