MEDICARE: JAY E DEGE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	042-0010384	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	12294	OTHER	NH	LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023029980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAY E DEGE MD

Provider Business Mailing Address
First Line	:	165 SHERMAN DR
Second Line	:
City	:	ST JOHNSBURY
State	:	VT
Zip	:	05819-9811
Country	:	US
Telephone Number	:	802-748-9405
Fax Number	:

Provider Business Practice Location Address
First Line	:	26 CEDAR LN
Second Line	:
City	:	DANVILLE
State	:	VT
Zip	:	05828-9751
Country	:	US
Telephone Number	:	802-684-2275
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	10/10/2023

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Directions to “ JAY E DEGE MD” Practice Location

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