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NPI Code Detail

MEDICARE: BLOOMSBURG PHYSICIANS SERVICES

MEDICARE: BLOOMSBURG PHYSICIANS SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery Physician

General Provider Information

NPI Number : 1235306879
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLOOMSBURG PHYSICIANS SERVICES
Provider Business Mailing Address
First Line : 549 FAIR ST
Second Line : PO BOX 919
City : BLOOMSBURG
State : PA
Zip : 17815-1419
Country : US
Telephone Number : 570-387-2100
Fax Number :
Provider Business Practice Location Address
First Line : 480 CENTRAL RD
Second Line :
City : BLOOMSBURG
State : PA
Zip : 17815-3121
Country : US
Telephone Number : 570-387-6150
Fax Number : 570-387-6185
Authorized Official
Title or Position : CEO
Name : MR. REGIS CABONOR
Credential :
Telephone Number : 570-387-2100
Provider Enumeration Date : 05/13/2008
Last Update Date : 09/09/2008

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Directions to “BLOOMSBURG PHYSICIANS SERVICES ” Practice Location

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