Provider Demographics
NPI:1518072602
Name:LORD, STEVEN M (OD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:M
Last Name:LORD
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:50 MAIN RD N
Mailing Address - Street 2:SUITE A
Mailing Address - City:HAMPDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04444-1307
Mailing Address - Country:US
Mailing Address - Phone:207-862-6169
Mailing Address - Fax:207-862-4333
Practice Address - Street 1:50 MAIN RD N
Practice Address - Street 2:SUITE A
Practice Address - City:HAMPDEN
Practice Address - State:ME
Practice Address - Zip Code:04444-1307
Practice Address - Country:US
Practice Address - Phone:207-862-6169
Practice Address - Fax:207-862-4333
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2023-07-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MEOPT769152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME125310099Medicaid
ME125310099Medicaid
MEMM330401Medicare PIN
ME0919450001Medicare NSC