GREEN MOUNTAIN PLASTIC AND RECONSTRUCTIVE SURGERY NPI 1598278137

NPI Information

  • NPI: 1598278137
  • Provider Name: GREEN MOUNTAIN PLASTIC AND RECONSTRUCTIVE SURGERY
  • Classification: Plastic Surgery - 208200000X
  • Entity Type: Organization
  • Address: 354 MOUNTAIN VIEW DR STE 300
    COLCHESTER, VT
    ZIP 05446
  • Phone: (802) 864-0192

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NPI Details

GREEN MOUNTAIN PLASTIC AND RECONSTRUCTIVE SURGERY is a plastic surgery in Colchester, VT. The provider is a plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. GREEN MOUNTAIN PLASTIC AND RECONSTRUCTIVE SURGERY NPI is 1598278137. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

354 MOUNTAIN VIEW DR STE 300
COLCHESTER, VT
ZIP 05446-988
Phone: (802) 864-0192
Fax: (802) 860-4919

The provider's authorized official is Donald R Laub .
The authorized official title is Physician and has the following contact phone number (802) 598-9619.

The enumeration date for this NPI number is 11/6/2017 and was last updated on 11/6/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208200000XPlastic Surgery42-0008887VERMONTYes
22082S0105XPlastic SurgerySurgery of the Hand42-0008887VERMONTNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1OVN1072MEDICAIDVERMONT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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