Organization
EYECARE OF VERMONT, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JON D ERIKSSON O.D. (OWNER MANAGER)
(802) 878-5509
Entity
Organization
Contact information
Practice address
230 COLLEGE ST, BURLINGTON, VT 05401-8352
(802) 658-3330
(802) 658-7464
Mailing address
230 COLLEGE ST, BURLINGTON, VT 05401-8352
(802) 658-3330
(802) 658-7464
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
030-0000156
VT
152W00000X
Optometrist
Primary
030-0000338
VT
152WL0500X
Low Vision Rehabilitation Optometrist
030-0000265
VT
152WL0500X
Low Vision Rehabilitation Optometrist
030-0000293
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39218
BLUECROSS/BLUESHIELD
VT
01
—
CG0391
RAILROAD MEDICARE
VT
05
—
OVN2193
—
VT
Enumeration date
10/12/2006
Last updated
03/13/2014
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