Provider Demographics
NPI:1831115724
Name:DOIRON, RICHARD J (OD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:J
Last Name:DOIRON
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 1:2 MEDICAL CENTER DRIVE
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005
Mailing Address - Country:US
Mailing Address - Phone:207-284-6351
Mailing Address - Fax:207-284-9681
Practice Address - Street 1:2 MEDICAL CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005
Practice Address - Country:US
Practice Address - Phone:207-284-6351
Practice Address - Fax:207-284-9681
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME6080PT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME109420000Medicaid
T31704Medicare UPIN
ME109420000Medicaid