Provider Demographics
NPI:1841364650
Name:ARMSTRONG, ANDREW C G (OD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:C G
Last Name:ARMSTRONG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 HIGHLAND ST PO BOX 119
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03264
Mailing Address - Country:US
Mailing Address - Phone:603-536-1443
Mailing Address - Fax:
Practice Address - Street 1:81 HIGHLAND ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03264
Practice Address - Country:US
Practice Address - Phone:603-536-1443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH387152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
090228040NH01OtherANTHEM
NH83582280Medicaid
T78193Medicare UPIN
NH83582280Medicaid