Provider Demographics
NPI:1558619544
Name:SANBORN, JAMES ARTHUR (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ARTHUR
Last Name:SANBORN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:748 LONG HILL RD
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340-4273
Mailing Address - Country:US
Mailing Address - Phone:860-445-4412
Mailing Address - Fax:860-449-0343
Practice Address - Street 1:748 LONG HILL RD
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-4273
Practice Address - Country:US
Practice Address - Phone:860-445-4412
Practice Address - Fax:860-449-0343
Is Sole Proprietor?:No
Enumeration Date:2012-08-22
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002879152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist