Healthcare Provider Details

I. General information

NPI: 1770524563
Provider Name (Legal Business Name): GETTYSBURG SURGICAL ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 03/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 S WASHINGTON ST 3RD FLOOR SUITE C
GETTYSBURG PA
17325-2500
US

IV. Provider business mailing address

450 S WASHINGTON ST 3RD FLOOR SUITE C
GETTYSBURG PA
17325-2500
US

V. Phone/Fax

Practice location:
  • Phone: 717-334-8141
  • Fax: 717-334-1885
Mailing address:
  • Phone: 717-334-8141
  • Fax: 717-334-1885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY R MCKEE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 717-334-8141