Provider Demographics
NPI:1710054390
Name:NOYES, JOHN PAUL (OD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PAUL
Last Name:NOYES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2443 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:SECANE
Mailing Address - State:PA
Mailing Address - Zip Code:19018-2825
Mailing Address - Country:US
Mailing Address - Phone:610-328-3272
Mailing Address - Fax:
Practice Address - Street 1:30 MEDICAL CENTER BLVD STE 104
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-3955
Practice Address - Country:US
Practice Address - Phone:610-874-5261
Practice Address - Fax:610-874-0318
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG828152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01480732Medicaid
PAU29192Medicare UPIN
PA01480732Medicaid