| |
99 Hospital St Ridgway PA 15853-1948 | |
(814) 788-5660 | |
(814) 788-5663 |
Full Name | |
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Speciality | Internal Medicine |
Location | 99 Hospital St, Ridgway, Pennsylvania |
Authorized Official Name and Position | Brian S 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: (814) 788-5660 | 99 Hospital St Ridgway PA 15853-1948 Ph: (814) 788-5660 |
NPI Number | 1023346673 |
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Provider Enumeration Date | 11/19/2009 |
Last Update Date | 10/20/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023346673 | NPI | - | NPPES |
106218 | Other | PA | MEDICARE PTAN |
089128 | Other | PA | MEDICARE PTAN |
1007740880070 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (Pennsylvania) | Secondary |
207R00000X | Internal Medicine | (Pennsylvania) | Primary |
Fernan Family Practice Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 200 S. Mill St., Ridgway, PA 15853 Phone: 814-772-0722 Fax: 814-772-6934 |