Healthcare Provider Details

I. General information

NPI: 1396678314
Provider Name (Legal Business Name): JAMES O'HANLON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 MORRISVILLE PLZ
MORRISVILLE VT
05661-4482
US

IV. Provider business mailing address

66 MORRISVILLE PLZ
MORRISVILLE VT
05661-4482
US

V. Phone/Fax

Practice location:
  • Phone: 802-888-8320
  • Fax:
Mailing address:
  • Phone: 802-888-8320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number0970136912
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: