Provider Demographics
NPI:1194855361
Name:SPECIALISTS IN ULTRASOUND, INC.
Entity Type:Organization
Organization Name:SPECIALISTS IN ULTRASOUND, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-238-6512
Mailing Address - Street 1:PO BOX 64824
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05406-4824
Mailing Address - Country:US
Mailing Address - Phone:802-655-0058
Mailing Address - Fax:
Practice Address - Street 1:463 MOUNTAIN VIEW DR
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-5966
Practice Address - Country:US
Practice Address - Phone:802-238-6512
Practice Address - Fax:802-350-2101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1010306Medicaid
VT1010306Medicaid