Healthcare Provider Details

I. General information

NPI: 1891810719
Provider Name (Legal Business Name): WILLIAM S HOLMES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 SMITH ST
WOODSVILLE NH
03785-1233
US

IV. Provider business mailing address

50 SMITH ST
WOODSVILLE NH
03785-1233
US

V. Phone/Fax

Practice location:
  • Phone: 603-747-3190
  • Fax: 603-747-2946
Mailing address:
  • Phone: 603-747-3190
  • Fax: 603-747-2946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number319
License Number StateNH

VIII. Authorized Official

Name: DR. WILLIAM STANLEY HOLMES
Title or Position: OWNER
Credential: OD
Phone: 603-747-3190