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General NPI Number Information
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NPI Number | 1093577017
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Entity Type | Individual
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Provider Name | IAN THOMAS HEAD PARAMEDIC
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Gender | Male
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Dates
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Enumeration Date | 01/25/2024
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 24 AIRPORT RD
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City | WEST LEBANON
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State | NH
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Zip | 03784-1663
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Country | US
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Telephone | 603-298-5594
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Fax |
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Provider Business Mailing Address
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Address Line | 111 COLCHESTER AVE
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City | BURLINGTON
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State | VT
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Zip | 05401-1473
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Country | US
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Telephone | 802-847-0000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 055.0031845
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA2024-0042
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License Number State | NM
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