Healthcare Provider Details

I. General information

NPI: 1407253859
Provider Name (Legal Business Name): DR NATALIE TEYGART PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2014
Last Update Date: 09/24/2020
Certification Date: 09/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

939 WEST 38TH ST
ERIE PA
16508
US

IV. Provider business mailing address

939 WEST 38TH ST
ERIE PA
16508
US

V. Phone/Fax

Practice location:
  • Phone: 814-456-8105
  • Fax: 814-456-8126
Mailing address:
  • Phone: 814-456-8105
  • Fax: 814-456-8126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS014970
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NATALIE TEYGART
Title or Position: MANAGER
Credential: DO
Phone: 814-528-1695