Provider Demographics
NPI:1174519516
Name:LAMONTAGNE, DENIS JACQUES (DPM)
Entity type:Individual
Prefix:DR
First Name:DENIS
Middle Name:JACQUES
Last Name:LAMONTAGNE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:542 RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:ST JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819-1741
Mailing Address - Country:US
Mailing Address - Phone:802-748-1918
Mailing Address - Fax:802-748-1919
Practice Address - Street 1:542 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:ST JOHNSBURY
Practice Address - State:VT
Practice Address - Zip Code:05819-1741
Practice Address - Country:US
Practice Address - Phone:802-748-1918
Practice Address - Fax:802-748-1919
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT056-0000155213ES0103X
NH0259213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0303844Y0VT01OtherANTHEM BCBS OF NH
180790OtherCIGNA HEALTHCARE
NH30006563Medicaid
989503OtherMVP HEALTHCARE
VT0VN0820Medicaid
VT19128OtherVT BCBS
VTVN0820Medicare ID - Type Unspecified
NH0303844Y0VT01OtherANTHEM BCBS OF NH
989503OtherMVP HEALTHCARE