Provider Demographics
NPI:1134495054
Name:PARTRIDGE, TIMOTHY JOHN (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:JOHN
Last Name:PARTRIDGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 547
Mailing Address - Street 2:ATTN: FINANCE DEPARTMENT
Mailing Address - City:BARRE
Mailing Address - State:VT
Mailing Address - Zip Code:05641-0547
Mailing Address - Country:US
Mailing Address - Phone:802-485-4161
Mailing Address - Fax:802-485-4163
Practice Address - Street 1:87 PAINE MOUNTAIN DRIVE
Practice Address - Street 2:GREEN MOUNTAIN FAMILY PRACTICE
Practice Address - City:NORTHFIELD
Practice Address - State:VT
Practice Address - Zip Code:05663
Practice Address - Country:US
Practice Address - Phone:802-485-4161
Practice Address - Fax:802-485-4163
Is Sole Proprietor?:No
Enumeration Date:2012-03-26
Last Update Date:2016-08-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VT042.0013502207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine