MEDICARE: TODD A PAGE O.D.

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
1	152W00000X	Optometrist	030--0000350	VT

General Provider Information

NPI Number	:	1609039379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TODD A PAGE O.D.

Provider Business Mailing Address
First Line	:	81 RIVER ST
Second Line	:	SUITE 203
City	:	MONTPELIER
State	:	VT
Zip	:	05602-3792
Country	:	US
Telephone Number	:	802-223-3761
Fax Number	:	802-223-5270

Provider Business Practice Location Address
First Line	:	81 RIVER ST
Second Line	:	SUITE 203
City	:	MONTPELIER
State	:	VT
Zip	:	05602-3792
Country	:	US
Telephone Number	:	802-223-3761
Fax Number	:	802-223-5270

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2008
Last Update Date	:	05/11/2023

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