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ST. LUKE'S PHYSICIAN GROUP INC. NPI 1700984622


NPI Information

NPI: 1700984622
Provider Name: ST. LUKE'S PHYSICIAN GROUP, INC.

Doing Business As: SOUTH MOUNTAIN FAMILY PRACTICE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 39D0189866

Address:
1545 BROADWAY
BETHLEHEM, PA
ZIP 18015
Phone: (610) 865-6112
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ST. LUKE'S PHYSICIAN GROUP, INC. is a family medicine in Bethlehem, PA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. ST. LUKE'S PHYSICIAN GROUP, INC. NPI is 1700984622. The provider is registered as an organization entity type.
The provider Is Doing Business As South Mountain Family Practice.

The provider's business location address is:

1545 BROADWAY
BETHLEHEM, PA
ZIP 18015-901
Phone: (610) 865-6112
Fax: (610) 865-3307

The provider's authorized official is Dean W Evans .
The authorized official title is President and has the following contact phone number (610) 954-4991.

The CLIA number assigned to this NPI record is 39D0189866 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 9/21/2006 and was last updated on 5/11/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1310400000XAssisted Living FacilityPENNSYLVANIANo
2207Q00000XFamily MedicinePENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1812708MEDICARE PINPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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