Provider Demographics
NPI:1508913286
Name:ADDISON ASSOCIATES IN OBSTETRICS AND GYNECOLOGY
Entity Type:Organization
Organization Name:ADDISON ASSOCIATES IN OBSTETRICS AND GYNECOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:MALCOLM
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:802-388-6326
Mailing Address - Street 1:116 PORTER DR
Mailing Address - Street 2:PHYSICIANS BUILDING
Mailing Address - City:MIDDLEBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05753-8527
Mailing Address - Country:US
Mailing Address - Phone:802-388-6326
Mailing Address - Fax:
Practice Address - Street 1:116 PORTER DR
Practice Address - Street 2:PHYSICIANS BUILDING
Practice Address - City:MIDDLEBURY
Practice Address - State:VT
Practice Address - Zip Code:05753-8527
Practice Address - Country:US
Practice Address - Phone:802-388-6326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty