| Stish Family Practice Pc | |
|
600 Penn St West Hazleton PA 18202-1514 | |
| (570) 497-4940 | |
| (570) 497-4942 |
| Full Name | Stish Family Practice Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 600 Penn St, West Hazleton, Pennsylvania |
| Authorized Official Name and Position | Eugene Stish (PRESIDENT) |
| Authorized Official Contact | 5707881108 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stish Family Practice Pc Po Box 1388 Kingston PA 18704-0388 Ph: (570) 288-8881 | Stish Family Practice Pc 600 Penn St West Hazleton PA 18202-1514 Ph: (570) 497-4940 |
| NPI Number | 1992732689 |
|---|---|
| Provider Enumeration Date | 06/27/2006 |
| Last Update Date | 03/28/2017 |
| Medicare PECOS PAC ID | 5698722023 |
|---|---|
| Medicare Enrollment ID | O20050407000091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992732689 | NPI | - | NPPES |
| 514293 | Other | PA | PA BLUE SHIELD |
| 002708 | Other | FIRST PRIORITY HEALTH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Eugene Robert Stish |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891746962 PECOS PAC ID: 2961486741 Enrollment ID: I20041207000135 |
Geisinger Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6 Diana Ln, West Hazleton, PA 18202 Phone: 570-501-3760 Fax: 570-501-3761 | |
Geisinger Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 20 Diana Ln, West Hazleton, PA 18202 Phone: 570-790-2260 Fax: 570-790-2277 |