Provider Demographics
NPI:1871755876
Name:VEITH, JASON KEITH (DO)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:KEITH
Last Name:VEITH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:64 BROOKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19116-1217
Mailing Address - Country:US
Mailing Address - Phone:740-208-0051
Mailing Address - Fax:
Practice Address - Street 1:17 BELMONT AVE STE 1
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-3498
Practice Address - Country:US
Practice Address - Phone:802-257-0341
Practice Address - Fax:802-257-8834
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT032.0120720207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1028223Medicaid
NH3104684Medicaid