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Individual

DR. GARY B IRISH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
87 MAIN ST, ESSEX JCT, VT 05452-3234
(802) 878-6830
(802) 878-6315
Mailing address
87 MAIN ST, ESSEX JCT, VT 05452-3234
(802) 878-6830
(802) 878-6315

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0300000141
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
030427694
CBA
VT
01
58749
BCBS
VT
01
59298
VERMONT MANAGED CARE
VT
01
59V024
MVP
VT
01
6168371
CIGNA
VT
Enumeration date
09/29/2005
Last updated
04/30/2010
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