Healthcare Provider Details

I. General information

NPI: 1962750786
Provider Name (Legal Business Name): SANBORN EYE ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2012
Last Update Date: 08/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 SHEEP DAVIS ROAD
CONCORD NH
03301
US

IV. Provider business mailing address

859 PROVINCE RD
BARNSTEAD NH
03218
US

V. Phone/Fax

Practice location:
  • Phone: 617-756-0891
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number0869
License Number StateNH

VIII. Authorized Official

Name: DR. JAMES ARTHUR SANBORN
Title or Position: OPTOMETRIST
Credential: O.D.
Phone: 617-756-0891