Healthcare Provider Details

I. General information

NPI: 1649393208
Provider Name (Legal Business Name): PAUL MCMANUS O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 N MAIN ST
LACONIA NH
03246-2628
US

IV. Provider business mailing address

950 N MAIN ST
LACONIA NH
03246-2628
US

V. Phone/Fax

Practice location:
  • Phone: 603-524-5770
  • Fax: 603-524-2424
Mailing address:
  • Phone: 603-524-5770
  • Fax: 603-524-2424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number400
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number400
License Number StateNH
# 3
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number400
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: