| Phillip States, Md, Family Practice | |
|
81 Hillcrest Dr Suite 1300 Punxsutawney PA 15767-2605 | |
| (814) 938-3550 | |
| (814) 938-3679 |
| Full Name | Phillip States, Md, Family Practice |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 81 Hillcrest Dr, Punxsutawney, Pennsylvania |
| Authorized Official Name and Position | Phillip J States (OWNER/PROPRIETOR) |
| Authorized Official Contact | 8149383550 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phillip States, Md, Family Practice 81 Hillcrest Dr Suite 1300 Punxsutawney PA 15767-2605 Ph: (814) 938-3550 | Phillip States, Md, Family Practice 81 Hillcrest Dr Suite 1300 Punxsutawney PA 15767-2605 Ph: (814) 938-3550 |
| NPI Number | 1376865816 |
|---|---|
| Provider Enumeration Date | 02/25/2010 |
| Last Update Date | 12/20/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376865816 | NPI | - | NPPES |
| 393918 | Other | PA | CMS CERTIFICATION NUMBER |
| 1019257860003 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 393918 (Pennsylvania) | Primary |
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