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General NPI Number Information
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NPI Number | 1043491905
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Entity Type | Organization
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Legal Business Name | RONALD W. DOUVILLE PROFESSIONAL ASSOCIATION
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Dates
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Enumeration Date | 11/20/2007
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Last Update Date | 02/25/2016
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Provider Practice Location Address
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Address Line | 395 DANIEL WEBSTER HWY
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City | MERRIMACK
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State | NH
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Zip | 03054-4128
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Country | US
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Telephone | 603-424-4030
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Fax | 603-424-7277
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Provider Business Mailing Address
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Address Line | PO BOX 1059
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City | MERRIMACK
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State | NH
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Zip | 03054-1059
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Country | US
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Telephone | 603-424-4030
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Fax | 603-424-7277
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RONALD W DOUVILLE,
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Credential | OD
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Telephone | 603-424-4030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 355
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License Number State | NH
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