Healthcare Provider Details

I. General information

NPI: 1336484054
Provider Name (Legal Business Name): INTEGRATED PHYSICIANS GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2012
Last Update Date: 12/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3735 NAZARETH RD
EASTON PA
18045-8338
US

IV. Provider business mailing address

3735 NAZARETH RD
EASTON PA
18045-8338
US

V. Phone/Fax

Practice location:
  • Phone: 610-252-1175
  • Fax:
Mailing address:
  • Phone: 610-252-1175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. CHAND ROHATGI
Title or Position: OWNER
Credential: M.D.
Phone: 610-252-1175