Individual
JULI A LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1100 HINESBURG RD, SUITE 201, SOUTH BURLINGTON, VT 05403-7613
(802) 862-1808
Mailing address
1100 HINESBURG RD, SUITE 201, SOUTH BURLINGTON, VT 05403-7613
(802) 862-1808
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0420008600
VT
207W00000X
Ophthalmology Physician
255565-1
NY
207W00000X
Ophthalmology Physician
25565-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180019743
RAIL ROAD MEDICARE
VT
05
—
OVN0634
—
VT
Enumeration date
05/12/2006
Last updated
07/21/2022
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