Green Mountain Family Practice | |
63 Crescent Ave Northfield VT 05663-5704 | |
(802) 485-4161 | |
(802) 485-4163 |
Full Name | Green Mountain Family Practice |
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Speciality | Clinic/center - Primary Care |
Location | 63 Crescent Ave, Northfield, Vermont |
Authorized Official Name and Position | Craig Demming Sullivan (PARTNER) |
Authorized Official Contact | 8024854161 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Green Mountain Family Practice 63 Crescent Ave Northfield VT 05663-5704 Ph: (802) 485-4161 | Green Mountain Family Practice 63 Crescent Ave Northfield VT 05663-5704 Ph: (802) 485-4161 |
NPI Number | 1194701623 |
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Provider Enumeration Date | 12/16/2005 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194701623 | NPI | - | NPPES |
0005666 | Medicaid | VT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |