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1205 Grampian Blvd Suite 3c Williamsport PA 17701-1970 | |
(570) 320-7800 | |
(570) 320-7801 |
Full Name | |
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Speciality | Family Medicine |
Location | 1205 Grampian Blvd, Williamsport, Pennsylvania |
Authorized Official Name and Position | Melissa Davis (VP/COO) |
Authorized Official Contact | 5703207696 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1201 Grampian Blvd Williamsport PA 17701-1900 Ph: () - | 1205 Grampian Blvd Suite 3c Williamsport PA 17701-1970 Ph: (570) 320-7800 |
NPI Number | 1316975881 |
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Provider Enumeration Date | 06/30/2006 |
Last Update Date | 10/20/2015 |
Medicare PECOS PAC ID | 2264336460 |
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Medicare Enrollment ID | O20040709000389 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316975881 | NPI | - | NPPES |
880365 | Other | PA | HIGHMARK BLUE SHIELD |
0017300760158 | Medicaid | PA |
Provider Name | Matthew Meeker |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1518288935 PECOS PAC ID: 8921246018 Enrollment ID: I20131004000007 |
Provider Name | Kelly D Douglass |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598198525 PECOS PAC ID: 4082841762 Enrollment ID: I20131231000204 |
Provider Name | Leeanna Lyne |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1144517483 PECOS PAC ID: 4082852157 Enrollment ID: I20140904001555 |
Provider Name | Morgan Rogers |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1326498726 PECOS PAC ID: 8325330087 Enrollment ID: I20191002002892 |
Provider Name | Cameron P Glagola |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1477046845 PECOS PAC ID: 2567711179 Enrollment ID: I20210827000113 |
Provider Name | Laura Nicole Maxwell-rankin |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1447951702 PECOS PAC ID: 5991170243 Enrollment ID: I20230419000370 |
Geisinger-hm Joint Venture, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1824 E 3rd St, Williamsport, PA 17701 Phone: 570-601-2200 Fax: 570-601-2202 | |
Open Arms Internal Medicine & Pediatrics, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3155 Lycoming Creek Rd, Williamsport, PA 17701 Phone: 570-244-1877 | |