Healthcare Provider Details

I. General information

NPI: 1851390140
Provider Name (Legal Business Name): JOSEPH PAUL VILOGI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 HILLTOP DR
CLARKS SUMMIT PA
18411-2701
US

IV. Provider business mailing address

825 HILLTOP DR
CLARKS SUMMIT PA
18411-2701
US

V. Phone/Fax

Practice location:
  • Phone: 570-586-7828
  • Fax: 570-586-1375
Mailing address:
  • Phone: 570-586-7828
  • Fax: 570-586-1375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMDO24047E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: