Dr Fotis G Mystakas, MD | |
912 Russell Dr, Lebanon, PA 17042-7485 | |
(717) 272-7971 | |
(717) 272-1241 |
Full Name | Dr Fotis G Mystakas |
---|---|
Gender | Male |
Speciality | Orthopaedic Surgery |
Location | 912 Russell Dr, Lebanon, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1114993334 | NPI | - | NPPES |
127119 | Other | PA | MEDICARE |
000643495 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207X00000X | Orthopaedic Surgery | MD034196L (Pennsylvania) | Primary |
Entity Name | Wellspan Medical Group |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1750480299 PECOS PAC ID: 1951213115 Enrollment ID: O20040220000815 |
Mailing Address | Practice Location Address |
---|---|
Dr Fotis G Mystakas, MD 3421 Concord Rd, York, PA 17402-9001 Ph: (717) 272-7971 | Dr Fotis G Mystakas, MD 912 Russell Dr, Lebanon, PA 17042-7485 Ph: (717) 272-7971 |
Sean E Slaven, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 912 Russell Dr, Lebanon, PA 17042 Phone: 717-272-7971 | |
David G Kuntz Jr., MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 912 Russell Dr, Lebanon, PA 17042 Phone: 717-272-7971 Fax: 717-272-1241 | |
Dr. David J Overholt, M.D. Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 912 Russell Dr, Lebanon, PA 17042 Phone: 717-272-7971 Fax: 717-272-1241 | |
Dr. Victor J Faralli, M.D. Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 912 Russell Dr, Lebanon, PA 17042 Phone: 717-272-7971 Fax: 717-272-1241 | |
Dr. Frederick Lewis Jones, MD Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 1700 S Lincoln Ave, Lebanon, PA 17042 Phone: 717-272-6621 Fax: 717-228-5982 | |
Dr. Scott M. Williams, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 912 Russell Dr, Lebanon, PA 17042 Phone: 717-272-7971 Fax: 717-272-1241 |