Kingsbauer, Matthew B
Kingsbauer, Matthew B is an individual 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 / Family Medicine, which is considered as his primary health care specialty. Kingsbauer, Matthew B can be contacted via phone (802) 773-3386.Contact Information
Primary practice address
215 Stratton Rd
Rutland VT 05701-4621
Phone: (802) 773-3386
Fax: (802) 773-4578
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | DO000001622 | Tennessee |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 032-0072647 | Vermont |
Profile Details
| NPI number | 1720039704 |
|---|---|
| LBN Legal business name | Kingsbauer, Matthew B |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 13th, 2006 |
| Last updated | Jul 20th, 2015 - about 9 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 | 1720039704 | NPPES |
| Vermont | MEDICAID | 1018489 |
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