Jimmo, Brad Lee
Jimmo, Brad Lee is an sole proprietor health care provider with primary practice located at 215 Stratton Rd , Rutland VT 05701-4621. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Jimmo, Brad Lee can be contacted via phone (802) 775-7745.Contact Information
Primary practice address
215 Stratton Rd
Rutland VT 05701-4621
Phone: (802) 775-7745
Fax: (802) 775-5155
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 042-0010388 | Vermont |
Profile Details
| NPI number | 1437184637 |
|---|---|
| LBN Legal business name | Jimmo, Brad Lee |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 12th, 2006 |
| Last updated | Mar 15th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1437184637 | NPPES |
| Vermont | MEDICAID | 1008803 |
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