MEDICARE: JULI A LARSON PC VERMONT EYE ASSOCIATES

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	261QS0132X	Ophthalmologic Surgery Clinic/Center	0420008600	VT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DB9414	OTHER	VT	RAIL ROAD MEDICARE

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

General Provider Information

NPI Number	:	1578511945
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JULI A LARSON PC VERMONT EYE ASSOCIATES

Provider Business Mailing Address
First Line	:	1100 HINESBURG RD
Second Line	:	SUITE 201
City	:	SOUTH BURLINGTON
State	:	VT
Zip	:	05403-7613
Country	:	US
Telephone Number	:	802-862-1808
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 HINESBURG RD
Second Line	:	SUITE 201
City	:	SOUTH BURLINGTON
State	:	VT
Zip	:	05403-7613
Country	:	US
Telephone Number	:	802-862-1808
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. JULI LARSON
Credential	:	M.D.
Telephone Number	:	802-862-1808

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	07/06/2020

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