Organization
DANIELSON SURGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH S DANIELSON M.D. (OWNER)
(802) 748-2984
Entity
Organization
Contact information
Practice address
1290 HOSPITAL DR, ST JOHNSBURY, VT 05819-9205
(802) 748-2984
Mailing address
1290 HOSPITAL DR, ST JOHNSBURY, VT 05819-9205
(802) 748-2984
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
I3397
RAIL ROAD MEDICARE
VT
05
—
OVN1579
—
VT
Enumeration date
05/08/2006
Last updated
04/06/2012
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