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NPI Code Detail

MEDICARE: SEAN R KULL OD

MEDICARE: SEAN R KULL OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristOPT825ME

General Provider Information

NPI Number : 1447432570
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEAN R KULL OD
Provider Business Mailing Address
First Line : 2 SYLVAN ROAD
Second Line :
City : ORONO
State : ME
Zip : 04473-3697
Country : US
Telephone Number : 207-827-4802
Fax Number : 207-827-4545
Provider Business Practice Location Address
First Line : 2 SYLVAN ROAD
Second Line :
City : ORONO
State : ME
Zip : 04473-3697
Country : US
Telephone Number : 207-827-4802
Fax Number : 207-827-4545
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2007
Last Update Date : 04/15/2008

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Directions to “ SEAN R KULL OD” Practice Location

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