Organization
PEDIATRIC ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROL E. PERKINS (OFFICE MANAGER)
(802) 786-2491
Entity
Organization
Contact information
Practice address
1 GENERAL WING RD, RUTLAND, VT 05701-4681
(802) 786-2491
(802) 775-6141
Mailing address
1 GENERAL WING RD, RUTLAND, VT 05701-4681
(802) 786-2491
(802) 775-6141
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0420008063
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006105
—
VT
01
—
1737
CDPHP
—
05
—
372101
—
NY
01
—
6105
VT BLUE CROSS BLUE SHIELD
VT
Enumeration date
03/26/2007
Last updated
08/22/2020
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