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Organization

RICHMOND PEDIATRIC & ADOLESCENT MEDICINE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PAUL J PARKER MD (PHYSICIAN)
(802) 434-5090
Entity
Organization

Contact information

Practice address
12 BURNETT CT, RICHMOND, VT 05477-4410
(802) 434-5090
(802) 329-2144
Mailing address
12 BURNETT CT, RICHMOND, VT 05477-4410
(802) 434-5090
(802) 329-2144

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0420010554
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1011571
VT
01
RICH00068256
BCBS GROUP ID #
VT
Enumeration date
10/03/2006
Last updated
12/08/2010
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