Glen R Lovejoy, MD | |
115 Porter Drive, Porter Hospital, Middlebury, VT 05753 | |
(802) 388-4001 | |
(802) 388-5612 |
Full Name | Glen R Lovejoy |
---|---|
Gender | Male |
Speciality | Emergency Medicine |
Location | 115 Porter Drive, Middlebury, Vermont |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1154413615 | NPI | - | NPPES |
0009688 | Medicaid | VT | |
3843 | Medicaid | NY | |
77V126 | Other | VT | MVP |
3843 | Other | VT | BCBS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 420007650 (Vermont) | Primary |
Entity Name | Fairview Hospital |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1942474176 PECOS PAC ID: 1254240773 Enrollment ID: O20081020000175 |
Mailing Address | Practice Location Address |
---|---|
Glen R Lovejoy, MD 30 Cobb City Rd, Colebrook, CT 06021-1121 Ph: () - | Glen R Lovejoy, MD 115 Porter Drive, Porter Hospital, Middlebury, VT 05753 Ph: (802) 388-4001 |
Jessica H Wagener, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 115 Porter Drive, Porter Hospital, Middlebury, VT 05753 Phone: 802-388-4001 Fax: 802-388-5612 | |
Robert D Pitts, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 115 Porter Dr, Porter Hospital, Middlebury, VT 05753 Phone: 802-388-4001 Fax: 802-388-5612 | |
Amanda S. Young, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 115 Porter Drive, Middlebury, VT 05753 Phone: 802-388-5607 Fax: 802-388-5654 | |
William J Nowlan, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 115 Porter Drive, Porter Hospital, Middlebury, VT 05753 Phone: 802-388-4001 Fax: 802-388-5612 | |
Fred W Kniffin, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 115 Porter Drive, Porter Hospital, Middlebury, VT 05753 Phone: 802-388-4001 Fax: 802-388-5612 | |
Robert Rene Gosselin, Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 6a Maple St, Middlebury, VT 05753 Phone: 724-991-3254 |