MEDICARE: MARK JAMES LOBITZ DO CMD PC

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
1	208D00000X	General Practice Physician	OS005223-L	PA

General Provider Information

NPI Number	:	1295937548
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARK JAMES LOBITZ DO CMD PC

Provider Business Mailing Address
First Line	:	420 W 23RD ST
Second Line	:
City	:	HAZLE TOWNSHIP
State	:	PA
Zip	:	18202-1302
Country	:	US
Telephone Number	:	570-455-6000
Fax Number	:	570-455-7371

Provider Business Practice Location Address
First Line	:	420 W 23RD ST
Second Line	:
City	:	HAZLE TOWNSHIP
State	:	PA
Zip	:	18202-1302
Country	:	US
Telephone Number	:	570-455-6000
Fax Number	:	570-455-7371

Authorized Official
Title or Position	:	CORPORATE OFFICER
Name	:	DR. MARK JAMES LOBITZ
Credential	:	DO CMD
Telephone Number	:	570-455-6000

Provider Enumeration Date	:	05/31/2007
Last Update Date	:	06/16/2024

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