Basic Information
| Provider Information | |||||||||
| NPI: | 1396249991 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FORBES-MOBUS | ||||||||
| FirstName: | EMILY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19 ORCHARD ST | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | VT | ||||||||
| PostalCode: | 051562613 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8023764181 | ||||||||
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| Practice Location | |||||||||
| Address1: | 79 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | PUTNEY | ||||||||
| State: | VT | ||||||||
| PostalCode: | 053468318 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8022570341 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2018 | ||||||||
| LastUpdateDate: | 01/27/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 0600004747 | VT | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 2626919 | 05 | VT | MEDICAID | 3129364 | 05 | NH | MEDICAID |