Provider Demographics
NPI:1518059211
Name:QUIMBY, CARL ARTHUR (DO)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:ARTHUR
Last Name:QUIMBY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 AMHERST ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03064-1367
Mailing Address - Country:US
Mailing Address - Phone:603-882-5971
Mailing Address - Fax:
Practice Address - Street 1:163 AMHERST ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03064
Practice Address - Country:US
Practice Address - Phone:603-882-5971
Practice Address - Fax:603-882-7039
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH172152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3007553Medicaid
RE3460Medicare ID - Type Unspecified
NH3007553Medicaid