Provider Demographics
NPI:1073624946
Name:ALSOBROOK, ARTHUR D (JR, MD)
Entity Type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:D
Last Name:ALSOBROOK
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Gender:M
Credentials:JR, MD
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Mailing Address - Street 1:189 PROUTY DR
Mailing Address - Street 2:EMERGENCY DEPARTMENT
Mailing Address - City:NEWPORT
Mailing Address - State:VT
Mailing Address - Zip Code:05855-9326
Mailing Address - Country:US
Mailing Address - Phone:802-334-4111
Mailing Address - Fax:802-334-4146
Practice Address - Street 1:189 PROUTY DR
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:NEWPORT
Practice Address - State:VT
Practice Address - Zip Code:05855-9326
Practice Address - Country:US
Practice Address - Phone:802-334-4111
Practice Address - Fax:802-334-4146
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2009-06-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VT0420007127207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT00006157OtherBLUE SHIELD
VT0006157Medicaid
B73916Medicare UPIN
VT0006157Medicaid