Provider Demographics
NPI:1396810164
Name:HEBERT, ERIC J (OD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:J
Last Name:HEBERT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:32 SCHOOL STREET
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ROCKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04841-2841
Mailing Address - Country:US
Mailing Address - Phone:207-594-4171
Mailing Address - Fax:207-594-1267
Practice Address - Street 1:32 SCHOOL STREET
Practice Address - Street 2:SUITE 103
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-2841
Practice Address - Country:US
Practice Address - Phone:207-594-4171
Practice Address - Fax:207-594-1267
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2014-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MEOPT753152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME119600000Medicaid
ME119600000Medicaid
ME0424500001Medicare NSC
MET79478Medicare UPIN