Phillip States, Md, Family Practice | |
81 Hillcrest Dr Suite 1300 Punxsutawney PA 15767-2605 | |
(814) 938-3550 | |
(814) 938-3679 |
Full Name | Phillip States, Md, Family Practice |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 81 Hillcrest Dr, Punxsutawney, Pennsylvania |
Authorized Official Name and Position | Phillip J States (OWNER/PROPRIETOR) |
Authorized Official Contact | 8149383550 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Phillip States, Md, Family Practice 81 Hillcrest Dr Suite 1300 Punxsutawney PA 15767-2605 Ph: (814) 938-3550 | Phillip States, Md, Family Practice 81 Hillcrest Dr Suite 1300 Punxsutawney PA 15767-2605 Ph: (814) 938-3550 |
NPI Number | 1376865816 |
---|---|
Provider Enumeration Date | 02/25/2010 |
Last Update Date | 12/20/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1376865816 | NPI | - | NPPES |
393918 | Other | PA | CMS CERTIFICATION NUMBER |
1019257860003 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 393918 (Pennsylvania) | Primary |
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