| Hazleton Family Practice | |
|
420 W 23rd St Hazle Township PA 18202-1302 | |
| (570) 455-6000 | |
| (570) 455-7371 |
| Full Name | Hazleton Family Practice |
|---|---|
| Speciality | General Practice |
| Location | 420 W 23rd St, Hazle Township, Pennsylvania |
| Authorized Official Name and Position | Mark James Lobitz (CORPORATE OFFICER) |
| Authorized Official Contact | 5704556000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hazleton Family Practice 420 W 23rd St Hazle Township PA 18202-1302 Ph: (570) 455-6000 | Hazleton Family Practice 420 W 23rd St Hazle Township PA 18202-1302 Ph: (570) 455-6000 |
| NPI Number | 1295937548 |
|---|---|
| Provider Enumeration Date | 05/31/2007 |
| Last Update Date | 06/16/2024 |
| Medicare PECOS PAC ID | 5597738310 |
|---|---|
| Medicare Enrollment ID | O20040818001033 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295937548 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | OS005223-L (Pennsylvania) | Primary |
| Provider Name | Mark J Lobitz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639141492 PECOS PAC ID: 6507821584 Enrollment ID: I20100714000555 |
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