Healthcare Provider Details

I. General information

NPI: 1962451013
Provider Name (Legal Business Name): GUTHRIE MEDICAL GROUP, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 02/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 SULLIVAN ST
CANTON PA
17724-1733
US

IV. Provider business mailing address

1 GUTHRIE SQ
SAYRE PA
18840-1625
US

V. Phone/Fax

Practice location:
  • Phone: 570-673-3197
  • Fax: 570-673-8297
Mailing address:
  • Phone: 570-888-5858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number003728
License Number StatePA

VIII. Authorized Official

Name: DR. JOSEPH A. SCOPELLITI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 570-888-5858