Provider Demographics
NPI:1952306250
Name:ERB, JOHN BYRON (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BYRON
Last Name:ERB
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 1:720 VILLAGE RD
Mailing Address - Street 2:
Mailing Address - City:EAST CORINTH
Mailing Address - State:VT
Mailing Address - Zip Code:05040-9783
Mailing Address - Country:US
Mailing Address - Phone:802-439-5321
Mailing Address - Fax:802-439-6783
Practice Address - Street 1:720 VILLAGE RD
Practice Address - Street 2:
Practice Address - City:EAST CORINTH
Practice Address - State:VT
Practice Address - Zip Code:05040-9783
Practice Address - Country:US
Practice Address - Phone:802-439-5321
Practice Address - Fax:802-439-6783
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0010766207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1010590Medicaid
G31543Medicare UPIN
VT1010590Medicaid