Healthcare Provider Details

I. General information

NPI: 1457626426
Provider Name (Legal Business Name): MR. ROBERT FRANKLIN HULVEY III
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2012
Last Update Date: 03/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 GOLF DRIVE
BUCK HILL FALLS PA
18323
US

IV. Provider business mailing address

150 GOLF DRIVE P.O.BOX 424
BUCK HILL FALLS PA
18323
US

V. Phone/Fax

Practice location:
  • Phone: 570-460-0337
  • Fax: 570-480-4091
Mailing address:
  • Phone: 570-460-0337
  • Fax: 570-480-4091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: