Provider Demographics
NPI:1598825721
Name:COLLINS, BARRY JOHN (OD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:JOHN
Last Name:COLLINS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 BIRNUM WOOD RD
Mailing Address - Street 2:
Mailing Address - City:STRATHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03885-2204
Mailing Address - Country:US
Mailing Address - Phone:603-772-8891
Mailing Address - Fax:
Practice Address - Street 1:74 PORTSMOUTH AVE
Practice Address - Street 2:STRATHAM FAMILY EYE CARE
Practice Address - City:STRATHAM
Practice Address - State:NH
Practice Address - Zip Code:03885
Practice Address - Country:US
Practice Address - Phone:603-772-7100
Practice Address - Fax:603-772-5376
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0551152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist