George Martin Connelly, PA-C, MHP
Individual provider Active NPI Orthopaedic Surgery Physician · Middlebury, VT
NPI 1174511802 · NPPES record last updated Dec 23, 2009
Key facts
- NPI
- 1174511802
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- License
- 0550030564 (VT)
- Practice address
- 1436 Exchange St
Middlebury, VT 05753-1185 - Phone
- (802) 388-3194
- Fax
- (802) 388-4881
- NPI assigned
- Oct 6, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0550030564 | VT | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Champlain Valley Orthopedics | Orthopaedic Surgery | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 0550030564 | VT | Yes |
Addresses
Primary practice location
1436 Exchange St
Middlebury, VT 05753-1185
Mailing address
1436 Exchange St
Middlebury, VT 05753-1185
Phone (802) 388-3194
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2001415 | Medicaid | VT |
Other providers in Middlebury, VT
- Brian Andrew Collins
- Brian Darnell Collins
- Columbus Medical Services, LLC
- Columbus Medical Services, LLC
- Nancy Joyce Conant
- Carolyn Conner
- Dayton Raymond Contois
- Timothy T Cope
- Francisco Jaime Corbalan
- Joanne Corbett
All providers in Middlebury, VT · Orthopaedic Surgery Physician in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 23, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.