Joseph C Pelletier, MD | |
44 S Main St, Randolph, VT 05060-1381 | |
(802) 728-2420 | |
(802) 728-2394 |
Full Name | Joseph C Pelletier |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 44 S Main St, Randolph, Vermont |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003828419 | NPI | - | NPPES |
1009801 | Medicaid | VT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 0420010598 (Vermont) | Primary |
Entity Name | Gifford Medical Center Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1942329446 PECOS PAC ID: 4880683663 Enrollment ID: O20040507000460 |
Entity Name | Gifford Health Care Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1013269430 PECOS PAC ID: 2668624982 Enrollment ID: O20121213000467 |
Mailing Address | Practice Location Address |
---|---|
Joseph C Pelletier, MD Po Box 2000, 44 South Main Street, Randolph, VT 05060-2000 Ph: (802) 728-2420 | Joseph C Pelletier, MD 44 S Main St, Randolph, VT 05060-1381 Ph: (802) 728-2420 |
Devin Alexander, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 44 S Main St, Randolph, VT 05060 Phone: 802-728-2420 | |
Louis A. Dinicola, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 44 S Main St, Randolph, VT 05060 Phone: 802-728-2420 Fax: 802-728-2613 | |
Elizabeth H. Jewett, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 44 S Main St, Randolph, VT 05060 Phone: 802-728-2420 Fax: 802-728-2613 |