Provider Demographics
NPI:1619931656
Name:HEBERT, ALBERT JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:JOSEPH
Last Name:HEBERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 147
Mailing Address - Street 2:
Mailing Address - City:WEST DANVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05873-0147
Mailing Address - Country:US
Mailing Address - Phone:802-274-3455
Mailing Address - Fax:
Practice Address - Street 1:489 OLD HOMESTEAD ROAD
Practice Address - Street 2:
Practice Address - City:WEST DANVILLE
Practice Address - State:VT
Practice Address - Zip Code:05873
Practice Address - Country:US
Practice Address - Phone:802-274-3455
Practice Address - Fax:802-748-3420
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0010916207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1011479Medicaid
NH3076808Medicaid
VT1011479Medicaid
NH3076808Medicaid