Carol R Boyes, PA

Individual provider Active NPI Pediatrics Physician · Brattleboro, VT

NPI 1326001025 · NPPES record last updated Jan 31, 2014

Key facts

NPI
1326001025
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
055-0030003 (VT)
Practice address
21 Belmont Ave
Brattleboro, VT 05301-7110
Phone
(802) 228-3905
Fax
(802) 258-4903
NPI assigned
Apr 11, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
055-0030003VTMDPediatrics Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 055-0030003 VT Yes

Addresses

Primary practice location

21 Belmont Ave
Brattleboro, VT 05301-7110

Mailing address

600 Blair Park Rd
Suite 190
Williston, VT 05495-7586
Phone (802) 872-4343

Other identifiers

IdentifierTypeStateIssuer
900351MedicaidVT

Other providers in Brattleboro, VT

All providers in Brattleboro, VT · Pediatrics Physician in Vermont

Sources for this page

Verify at the official NPI Registry.