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General NPI Number Information
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NPI Number | 1497828859
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Entity Type | Individual
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Provider Name | CLIFTON FREDERICK LORD MD
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Gender | Male
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 220 HOLIDAY DR
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City | WHITE RIVER JUNCTION
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State | VT
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Zip | 05001-2011
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Country | US
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Telephone | 802-674-9400
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Fax | 802-674-9410
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Provider Business Mailing Address
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Address Line | 220 HOLIDAY DR STE A
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City | WHITE RIVER JUNCTION
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State | VT
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Zip | 05001-2015
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Country | US
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Telephone | 802-674-9400
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Fax | 802-674-9410
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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 | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | 0420007259
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License Number State | VT
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