Healthcare Provider Details

I. General information

NPI: 1376512285
Provider Name (Legal Business Name): BARBARA R TRUSCOTT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BARBARA R HAUTZ PA-C

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 12/11/2019
Certification Date: 12/11/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HOSPITAL RD
PRINCE FREDERICK MD
20678-4017
US

IV. Provider business mailing address

321 MAIN ST SUITE 5H
JOHNSTOWN PA
15901-1632
US

V. Phone/Fax

Practice location:
  • Phone: 410-535-4000
  • Fax:
Mailing address:
  • Phone: 814-535-3310
  • Fax: 814-532-6618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC05674
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA052236
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberMA052236
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: