Mayer, Jack Lawrence

Mayer, Jack Lawrence is an individual health care provider with primary practice located at 44 Collins Dr Suite 202, Middlebury VT 05753-8528. He recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as his primary health care specialty. Mayer, Jack Lawrence can be contacted via phone (802) 388-1338.

Contact Information

Primary practice address
44 Collins Dr Suite 202 Middlebury VT 05753-8528
Phone: (802) 388-1338
Fax: (802) 388-8244
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 042-0004728 Vermont

Profile Details

NPI number 1639136559
LBN Legal business name Mayer, Jack Lawrence
Credentials M.D., FAAP
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Jul 9th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639136559 NPPES
Vermont MEDICAID 0004626
Vermont Other 26P885
Vermont Other 4626

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