Healthcare Provider Details
I. General information
NPI: 1982603791
Provider Name (Legal Business Name): JAMES P NAVALKOWSKY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/14/2005
Last Update Date: 03/20/2012
Certification Date:
Deactivation Date: 03/17/2006
Reactivation Date: 03/31/2006
III. Provider practice location address
418 CLOVERLEAF RD
ELIZABETHTOWN PA
17022-9320
US
IV. Provider business mailing address
418 CLOVERLEAF RD
ELIZABETHTOWN PA
17022-9320
US
V. Phone/Fax
- Phone: 717-653-1467
- Fax: 717-653-1001
- Phone: 717-653-1467
- Fax: 717-653-1001
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | MD030362E |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | MD030362E |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: