Organization
RICHARD D MORRISON
Active
Other names
Ethan Allen Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD D MORRISON MD (OWNER)
(802) 655-1122
Entity
Organization
Contact information
Practice address
28 VERMONT AVE, COLCHESTER, VT 05446-3125
(802) 655-1122
(802) 655-1124
Mailing address
28 VERMONT AVE, COLCHESTER, VT 05446-3125
(802) 655-1122
(802) 655-1124
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0420002588
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00004561
BLUECROSS
VT
05
—
0004561
—
VT
01
—
4656001
APEX
VT
01
—
BX4049
MEDICARE PTAN
VT
01
—
VT4561
MEDICARE LEGACY
VT
Enumeration date
02/27/2007
Last updated
12/06/2007
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