| Ethan Allen Medical Center | |
|
28 Vermont Ave Colchester VT 05446-3125 | |
| (802) 655-1122 | |
| (802) 655-1124 |
| Full Name | Ethan Allen Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 28 Vermont Ave, Colchester, Vermont |
| Authorized Official Name and Position | Richard D Morrison (OWNER) |
| Authorized Official Contact | 8026551122 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ethan Allen Medical Center 28 Vermont Ave Colchester VT 05446-3125 Ph: (802) 655-1122 | Ethan Allen Medical Center 28 Vermont Ave Colchester VT 05446-3125 Ph: (802) 655-1122 |
| NPI Number | 1659408839 |
|---|---|
| Provider Enumeration Date | 02/27/2007 |
| Last Update Date | 12/06/2007 |
| Medicare PECOS PAC ID | 6103891593 |
|---|---|
| Medicare Enrollment ID | O20040830000449 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659408839 | NPI | - | NPPES |
| BX4049 | Other | VT | MEDICARE PTAN |
| 0004561 | Medicaid | VT | |
| 00004561 | Other | VT | BLUECROSS |
| VT4561 | Other | VT | MEDICARE LEGACY |
| 4656001 | Other | VT | APEX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 0420002588 (Vermont) | Primary |
Vermont Information Processing Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 Watertower Cir Ste 201, Colchester, VT 05446 Phone: 802-698-8583 | |
Vermont Gastroenterology Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 875 Roosevelt Hwy, Suite 132, Colchester, VT 05446 Phone: 802-864-7483 Fax: 802-660-4337 | |
Hobie Fuerstman Do Plc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 905 Roosevelt Hwy Ste 210, Colchester, VT 05446 Phone: 802-879-6544 | |
Carol J. Gardner, Do Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 905 Roosevelt Hwy, Suite 210, Colchester, VT 05446 Phone: 802-879-6544 Fax: 802-879-0022 | |
Ronald B. Miller, Phd, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 123 Ethan Allen Ave, Colchester, VT 05446 Phone: 802-654-7075 |