Healthcare Provider Details

I. General information

NPI: 1619931656
Provider Name (Legal Business Name): ALBERT JOSEPH HEBERT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 03/29/2023
Certification Date: 03/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

489 OLD HOMESTEAD ROAD
WEST DANVILLE VT
05873
US

IV. Provider business mailing address

PO BOX 147
WEST DANVILLE VT
05873-0147
US

V. Phone/Fax

Practice location:
  • Phone: 802-274-3455
  • Fax: 802-748-3420
Mailing address:
  • Phone: 802-274-3455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number042-0010916
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: