Healthcare Provider Details

I. General information

NPI: 1992790067
Provider Name (Legal Business Name): LINDA BISSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 10/13/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 CEDAR LANE
DANVILLE VT
05828-9751
US

IV. Provider business mailing address

165 SHERMAN DRIVE
ST. JOHNSBURY VT
05819
US

V. Phone/Fax

Practice location:
  • Phone: 802-454-8336
  • Fax: 802-454-8339
Mailing address:
  • Phone: 802-748-9405
  • Fax: 802-748-4540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301069175
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number042-0011825
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: