Organization
JAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN A BISSON M.D. (OWNER)
(802) 863-0107
Entity
Organization
Contact information
Practice address
64 COLCHESTER AVENUE, BURLINGTON, VT 05401-1417
(802) 863-0107
(802) 658-9292
Mailing address
33 SUMMIT RIDGE, BURLINGTON, VT 05401-3911
(802) 863-0107
(802) 658-9292
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0420005559
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
69852
BCBS
VT
Enumeration date
04/17/2008
Last updated
04/17/2008
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