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Individual

JAMES TAUTFEST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
44 S MAIN ST, RANDOLPH, VT 05060-1381
(802) 728-7000
(802) 728-2613
Mailing address
44 S MAIN ST, RANDOLPH, VT 05060-1381
(802) 728-7000
(802) 728-2613

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
101-0017968
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1010580
VT
01
18466
BLUE CROSS PROVIDER #
VT
Enumeration date
03/07/2007
Last updated
06/15/2015
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