Healthcare Provider Details

I. General information

NPI: 1245428549
Provider Name (Legal Business Name): JOHN A. SCANLAND DPMPC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2007
Last Update Date: 10/11/2023
Certification Date: 10/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1834 MAIN ST
BLAKELY PA
18447-1370
US

IV. Provider business mailing address

1834 MAIN ST
BLAKELY PA
18447-1370
US

V. Phone/Fax

Practice location:
  • Phone: 570-489-4432
  • Fax: 570-489-8083
Mailing address:
  • Phone: 570-489-4432
  • Fax: 570-489-8083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN A. SCANLAND
Title or Position: PODIATRIST
Credential: DPMPC
Phone: 570-489-4432