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General NPI Number Information
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NPI Number | 1588616494
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Entity Type | Individual
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Provider Name | LANCE F. BROY M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 03/08/2024
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Provider Practice Location Address
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Address Line | 272 N MAIN STREET UNIT 101
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City | CAMBRIDGE
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State | VT
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Zip | 05444
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Country | US
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Telephone | 802-644-5114
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Fax | 802-888-6075
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Provider Business Mailing Address
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Address Line | PO BOX 749
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City | MORRISVILLE
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State | VT
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Zip | 05661-0749
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Country | US
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Telephone | 802-851-8619
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Fax | 802-851-8716
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35-08-3771
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 042.0017249
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License Number State | VT
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