Provider Demographics
NPI:1134115090
Name:BABB, LORNE MARSHALL NEWTON (MD)
Entity Type:Individual
Prefix:DR
First Name:LORNE
Middle Name:MARSHALL NEWTON
Last Name:BABB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:600 BLAIR PARK RD STE 285
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495-7586
Mailing Address - Country:US
Mailing Address - Phone:802-288-1140
Mailing Address - Fax:802-288-1144
Practice Address - Street 1:84 WATER TOWER RD
Practice Address - Street 2:SUITE 1
Practice Address - City:ENOSBURG FALLS
Practice Address - State:VT
Practice Address - Zip Code:05450-6097
Practice Address - Country:US
Practice Address - Phone:802-933-6664
Practice Address - Fax:802-933-8333
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0420007785207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0009278Medicaid
VT0009278Medicaid
VTBX5485Medicare PIN
VTE20192Medicare UPIN