Provider Demographics
NPI:1053377143
Name:RICHARDS, JOHN STEWART (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:STEWART
Last Name:RICHARDS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 32
Mailing Address - Street 2:WHITE MOUNTAIN EYE CARE, ADMINISTRATION
Mailing Address - City:ANDOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03216-0032
Mailing Address - Country:US
Mailing Address - Phone:603-735-6060
Mailing Address - Fax:603-536-3136
Practice Address - Street 1:103 BOULDER POINT DRIVE
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03264-3156
Practice Address - Country:US
Practice Address - Phone:603-536-1284
Practice Address - Fax:603-536-3136
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH6187207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH81186956Medicaid
5813500OtherAETNA
0106956Y0NH02OtherBC ANTHEM
E41245Medicare UPIN
NH81186956Medicaid