Healthcare Provider Details

I. General information

NPI: 1467407312
Provider Name (Legal Business Name): EYE GROUP OF LANCASTER COUNTY, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 12/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 FOREST RD
DENVER PA
17517-9031
US

IV. Provider business mailing address

340 FOREST RD
DENVER PA
17517-9031
US

V. Phone/Fax

Practice location:
  • Phone: 717-336-1751
  • Fax: 717-336-2478
Mailing address:
  • Phone: 717-336-1751
  • Fax: 717-336-2478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD023391E
License Number StatePA

VIII. Authorized Official

Name: DR. JOSEPH LEROY CALKINS
Title or Position: MEMBER
Credential: M.D.
Phone: 717-336-1751