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SUSQUEHANNA PHYSICIAN SERVICES NPI 1780631226


NPI Information

NPI: 1780631226
Provider Name: SUSQUEHANNA PHYSICIAN SERVICES

Doing Business As: SUSQUEHANNA HEALTH MEDICAL GROUP

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
145 SHAFFER ST
SOUTH WILLIAMSPORT, PA
ZIP 17702
Phone: (570) 326-2447
Get Directions

SUSQUEHANNA PHYSICIAN SERVICES is a family medicine in South Williamsport, 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. SUSQUEHANNA PHYSICIAN SERVICES NPI is 1780631226. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Susquehanna Health Medical Group.

The provider's business location address is:

145 SHAFFER ST
SOUTH WILLIAMSPORT, PA
ZIP 17702-727
Phone: (570) 326-2447
Fax: (570) 326-1247

The provider's authorized official is Melissa Davis .
The authorized official title is Vp/coo and has the following contact phone number (570) 320-7696.

The enumeration date for this NPI number is 5/30/2006 and was last updated on 10/26/2015.


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
1363L00000XNurse PractitionerNo
2207Q00000XFamily MedicineYes

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
1888650OTHERPENNSYLVANIAHIGHMARK BLUE SHIELD
2CC0890MEDICARE PINPENNSYLVANIA
30017300760153MEDICAIDPENNSYLVANIA

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.