Marshall Keith Gardner, D.o., P.c. | |
15 Anthony Dr Richboro PA 18954-1328 | |
(215) 969-3013 | |
(215) 676-2522 |
Full Name | Marshall Keith Gardner, D.o., P.c. |
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Speciality | Family Medicine |
Location | 15 Anthony Dr, Richboro, Pennsylvania |
Authorized Official Name and Position | Fran Gardner (OFFICE MANAGER) |
Authorized Official Contact | 2159693013 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Marshall Keith Gardner, D.o., P.c. 15 Anthony Dr Richboro PA 18954-1328 Ph: (215) 969-3013 | Marshall Keith Gardner, D.o., P.c. 15 Anthony Dr Richboro PA 18954-1328 Ph: (215) 969-3013 |
NPI Number | 1891814018 |
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Provider Enumeration Date | 03/28/2007 |
Last Update Date | 11/14/2007 |
Medicare PECOS PAC ID | 8022283217 |
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Medicare Enrollment ID | O20111216000621 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891814018 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | OS003214L (Pennsylvania) | Primary |
Provider Name | Marshall K Gardner |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1750354783 PECOS PAC ID: 6002080173 Enrollment ID: I20111219000041 |
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