1821145921 NPI number — DR. CURTIS M HEALEY DC

Table of content: DR. CURTIS M HEALEY DC (NPI 1821145921)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821145921 NPI number — DR. CURTIS M HEALEY DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HEALEY
Provider First Name:
CURTIS
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821145921
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/21/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
108 WASHINGTON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BARRE
Provider Business Mailing Address State Name:
VT
Provider Business Mailing Address Postal Code:
05641-4214
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
802-479-3206
Provider Business Mailing Address Fax Number:
802-479-3348

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
108 WASHINGTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BARRE
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05641-4214
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
802-479-3206
Provider Business Practice Location Address Fax Number:
802-479-3348
Provider Enumeration Date:
01/04/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  006.0001149 , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 111N00000X , with the licence number: 0060001149 , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00068423 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 4254703 . This is a "CIGNA" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".