Provider Demographics
NPI:1356507388
Name:VERNON, MATTHEW R (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:R
Last Name:VERNON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:140 HOSPITAL DR STE 116
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05201-5010
Mailing Address - Country:US
Mailing Address - Phone:802-447-1836
Mailing Address - Fax:802-440-6097
Practice Address - Street 1:140 HOSPITAL DR STE 116
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:VT
Practice Address - Zip Code:05201-5010
Practice Address - Country:US
Practice Address - Phone:802-447-1836
Practice Address - Fax:802-440-6097
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2018-03-29
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Provider Licenses
StateLicense IDTaxonomies
VT042.00126402085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology