Healthcare Provider Details

I. General information

NPI: 1346309473
Provider Name (Legal Business Name): JUDY KAY ORTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 MAIN ST SUITE 1
BENNINGTON VT
05201-2670
US

IV. Provider business mailing address

901 MAIN ST SUITE 1
BENNINGTON VT
05201-2670
US

V. Phone/Fax

Practice location:
  • Phone: 802-442-6057
  • Fax: 802-447-1348
Mailing address:
  • Phone: 802-442-6057
  • Fax: 802-447-1348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: