MEDICARE: TIOGA HEALTH CARE PROVIDERS, INC

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	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1366881476
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIOGA HEALTH CARE PROVIDERS, INC

Provider Business Mailing Address
First Line	:	22 WALNUT ST
Second Line	:
City	:	WELLSBORO
State	:	PA
Zip	:	16901-1526
Country	:	US
Telephone Number	:	570-723-0600
Fax Number	:	570-724-2126

Provider Business Practice Location Address
First Line	:	9 WATER ST
Second Line	:
City	:	WELLSBORO
State	:	PA
Zip	:	16901-1117
Country	:	US
Telephone Number	:	570-724-2325
Fax Number	:	570-724-5855

Authorized Official
Title or Position	:	CFO
Name	:	RONALD M GILBERT JR.
Credential	:
Telephone Number	:	570-723-0600

Provider Enumeration Date	:	06/21/2013
Last Update Date	:	04/01/2015

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Directions to “TIOGA HEALTH CARE PROVIDERS, INC ” Practice Location

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