Healthcare Provider Details

I. General information

NPI: 1619552882
Provider Name (Legal Business Name): LEHIGH VALLEY PHYSICIAN GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2021
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3794 HECKTOWN RD STE 250
EASTON PA
18045-2355
US

IV. Provider business mailing address

PO BOX 783311
PHILADELPHIA PA
19178-3311
US

V. Phone/Fax

Practice location:
  • Phone: 484-546-5800
  • Fax: 484-544-0122
Mailing address:
  • Phone: 484-884-4500
  • Fax: 484-884-0699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER STEPHENS
Title or Position: SR VP & CHIEF VALUE OFFICER
Credential:
Phone: 484-884-4500