Healthcare Provider Details

I. General information

NPI: 1770681710
Provider Name (Legal Business Name): SCOTT M KRAUCHUNAS OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 DANIEL WEBSTER HWY
BELMONT NH
03220-3039
US

IV. Provider business mailing address

320 DANIEL WEBSTER HWY
BELMONT NH
03220-3039
US

V. Phone/Fax

Practice location:
  • Phone: 603-527-2035
  • Fax: 603-528-2021
Mailing address:
  • Phone: 603-527-2035
  • Fax: 603-528-2021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0781
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: