Healthcare Provider Details

I. General information

NPI: 1730132705
Provider Name (Legal Business Name): ROBERT JOHNS, MD PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

268 RIVER ST
SPRINGFIELD VT
05156-2306
US

IV. Provider business mailing address

PO BOX 910
GREENFIELD MA
01302-0910
US

V. Phone/Fax

Practice location:
  • Phone: 802-885-4561
  • Fax:
Mailing address:
  • Phone: 413-772-8500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number0420008477
License Number StateVT

VIII. Authorized Official

Name: DR. ROBERT JOHNS
Title or Position: PRESIDENT
Credential: MD
Phone: 802-885-4561