INTEGRATED MEDICAL GROUP P C NPI 1417911819

NPI Information

  • NPI: 1417911819
  • Provider Name: INTEGRATED MEDICAL GROUP P C
  • Classification: Surgery - 208600000X
  • Entity Type: Organization
  • Address: 48 TUNNEL RD
    SUITE 203
    POTTSVILLE, PA
    ZIP 17901
  • Phone: (570) 622-5455

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NPI Details

INTEGRATED MEDICAL GROUP P C is a surgery in Pottsville, PA. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. INTEGRATED MEDICAL GROUP P C NPI is 1417911819. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

48 TUNNEL RD
SUITE 203
POTTSVILLE, PA
ZIP 17901-875
Phone: (570) 622-5455
Fax: (570) 622-5493

The provider's authorized official is Lori Burns .
The authorized official title is Hr and has the following contact phone number (570) 622-5455.

The enumeration date for this NPI number is 4/13/2006 and was last updated on 11/19/2024.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208600000XSurgeryYes
22086S0129XSurgeryVascular SurgeryNo

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1100775174MEDICAIDPENNSYLVANIA

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: 11/21/2025

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