Healthcare Provider Details

I. General information

NPI: 1811099229
Provider Name (Legal Business Name): THOMAS CHITTENDEN HEALTH CENTER, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 06/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

586 OAK HILL ROAD
WILLISTON VT
05495-7103
US

IV. Provider business mailing address

586 OAK HILL ROAD
WILLISTON VT
05495-7103
US

V. Phone/Fax

Practice location:
  • Phone: 802-878-8131
  • Fax: 802-879-6853
Mailing address:
  • Phone: 802-878-8131
  • Fax: 802-879-6853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RACHEL ATKINS
Title or Position: BUSINESS MANAGER
Credential: P.A.
Phone: 802-878-8131