Organization
EYE VERMONT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLY SCHMIDT (OFFICE MANAGER)
(802) 863-3000
Entity
Organization
Contact information
Practice address
100 DORSET ST, SUITE 25, SOUTH BURLINGTON, VT 05403
(802) 863-3000
(802) 863-3001
Mailing address
100 DORSET ST, SUITE 25, SOUTH BURLINGTON, VT 05403-6241
(802) 863-3000
(802) 863-3001
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
315
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0VN3977
—
VT
01
—
DF3986
MEDICARE RAILROAD
VT
01
—
EYEV00069292
BLUE SHIELD OF VT
—
Enumeration date
05/28/2006
Last updated
06/27/2018
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