# PEDIATRIC ASSOCIATES, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780702118
- **Authorized official:** MRS. CAROL E. PERKINS (OFFICE MANAGER)
- **Authorized official phone:** (802) 786-2491

## Contact information

- **Practice address:** 1 GENERAL WING RD, RUTLAND, VT 05701-4681
- **Practice address phone:** (802) 786-2491
- **Practice address fax:** (802) 775-6141
- **Mailing address:** 1 GENERAL WING RD, RUTLAND, VT 05701-4681
- **Mailing address phone:** (802) 786-2491
- **Mailing address fax:** (802) 775-6141

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | 0420008063 | VT | Yes |

## Other

- **Enumeration date:** 03/26/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0006105 | — | VT |
| 01 | — | 1737 | CDPHP | — |
| 05 | — | 372101 | — | NY |
| 01 | — | 6105 | VT BLUE CROSS BLUE SHIELD | VT |