| Wellspan Family Medicine - North Fourth Street | |
|
30 N 4th St 2nd Floor Lebanon PA 17046-5606 | |
| (717) 274-0474 | |
| (717) 274-0673 |
| Full Name | Wellspan Family Medicine - North Fourth Street |
|---|---|
| Speciality | Family Medicine |
| Location | 30 N 4th St, Lebanon, Pennsylvania |
| Authorized Official Name and Position | Jody M Boger (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 7172707780 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellspan Family Medicine - North Fourth Street Po Box 300 Lebanon PA 17042-0300 Ph: (717) 270-7780 | Wellspan Family Medicine - North Fourth Street 30 N 4th St 2nd Floor Lebanon PA 17046-5606 Ph: (717) 274-0474 |
| NPI Number | 1316076961 |
|---|---|
| Provider Enumeration Date | 03/02/2007 |
| Last Update Date | 10/04/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316076961 | NPI | - | NPPES |
| 001864024 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207V00000X | Obstetrics & Gynecology | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
Nazeeri Family Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1023 Poplar St, Lebanon, PA 17042 Phone: 717-270-9446 Fax: 717-270-5669 | |
Agape Family Medicine, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 Cumberland St, Lebanon, PA 17042 Phone: 717-270-0335 Fax: 717-270-9740 | |
Penn Medicine Lghp Urgent Care Lebanon Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1701 Cornwall Rd Ste 101, Lebanon, PA 17042 Phone: 717-675-1788 Fax: 717-675-1800 | |
Penn Medicine Lghp Family Medicine Quentin Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1701 Cornwall Rd Ste 201, Lebanon, PA 17042 Phone: 717-675-1780 Fax: 717-675-1787 | |
Wellspan Good Samaritan Hospital Spu Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 252 South 4th Street, Lebanon, PA 17042 Phone: 717-270-7500 | |
Union Community Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 711 S 8th St, Lebanon, PA 17042 Phone: 717-299-6371 Fax: 717-325-8057 | |
Lebanon Family Health Service Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 615 Cumberland St, Lebanon, PA 17042 Phone: 717-273-6741 Fax: 717-273-6337 |