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General NPI Number Information
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NPI Number | 1164601779
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Entity Type | Organization
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Legal Business Name | STEVEN M LORD PA
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Dates
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Enumeration Date | 10/31/2007
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Last Update Date | 07/19/2023
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Provider Practice Location Address
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Address Line | 50 MAIN RD N SUITE A
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City | HAMPDEN
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State | ME
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Zip | 04444-1307
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Country | US
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Telephone | 207-862-6169
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Fax | 207-862-4333
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Provider Business Mailing Address
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Address Line | 50 MAIN RD N SUITE A
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City | HAMPDEN
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State | ME
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Zip | 04444-1307
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Country | US
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Telephone | 207-862-6169
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Fax | 207-862-4333
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEVEN M LORD
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Credential | OD
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Telephone | 207-862-6169
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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 | OPT769
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License Number State | ME
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