Provider Demographics
NPI:1609039379
Name:PAGE, TODD A (OD)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:A
Last Name:PAGE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 RIVER ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05602-3792
Mailing Address - Country:US
Mailing Address - Phone:802-223-3761
Mailing Address - Fax:802-223-5270
Practice Address - Street 1:81 RIVER ST
Practice Address - Street 2:SUITE 203
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-3792
Practice Address - Country:US
Practice Address - Phone:802-223-3761
Practice Address - Fax:802-223-5270
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-03
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VT030--0000350152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist