MEDICARE: CRAIG E PURSELL DO

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	207Q00000X	Family Medicine Physician	OS003470L	PA

General Provider Information

NPI Number	:	1891846689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRAIG E PURSELL DO

Provider Business Mailing Address
First Line	:	4570 PENNS VALLEY RD
Second Line	:	SUITE 1
City	:	SPRING MILLS
State	:	PA
Zip	:	16875-8500
Country	:	US
Telephone Number	:	814-422-8873
Fax Number	:	814-422-8037

Provider Business Practice Location Address
First Line	:	4570 PENNS VALLEY RD
Second Line	:	SUITE 1
City	:	SPRING MILLS
State	:	PA
Zip	:	16875-8500
Country	:	US
Telephone Number	:	814-422-8873
Fax Number	:	814-422-8037

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	02/17/2014

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