MEDICARE: KRISTA HAIGHT M.D.

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	207W00000X	Ophthalmology Physician	MT187752	PA

General Provider Information

NPI Number	:	1881810505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTA HAIGHT M.D.

Provider Business Mailing Address
First Line	:	1290 HOSPITAL DR
Second Line	:	SUITE 5
City	:	SAINT JOHNSBURY
State	:	VT
Zip	:	05819-9205
Country	:	US
Telephone Number	:	802-748-8126
Fax Number	:	802-748-2208

Provider Business Practice Location Address
First Line	:	1290 HOSPITAL DR
Second Line	:	SUITE 5
City	:	SAINT JOHNSBURY
State	:	VT
Zip	:	05819-9205
Country	:	US
Telephone Number	:	802-748-8126
Fax Number	:	802-748-2208

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

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	12/31/2012

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