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761 Johnsonburg Rd Suite 240 Saint Marys PA 15857-3483 | |
(814) 788-8183 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 761 Johnsonburg Rd, Saint Marys, Pennsylvania |
Authorized Official Name and Position | Brian Kline (CFO) |
Authorized Official Contact | 8143756377 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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100 Hospital Ave Du Bois PA 15801-1440 Ph: () - | 761 Johnsonburg Rd Suite 240 Saint Marys PA 15857-3483 Ph: (814) 788-8183 |
NPI Number | 1124403035 |
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Provider Enumeration Date | 07/22/2015 |
Last Update Date | 07/22/2015 |
Identifier | Type | State | Issuer |
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1124403035 | NPI | - | NPPES |
100774088 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
363A00000X | Physician Assistant | (* (Not Available)) | Secondary |