Healthcare Provider Details

I. General information

NPI: 1477565968
Provider Name (Legal Business Name): SURGICAL PHYSICIANS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 06/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

891 S ARLINGTON AVE
HARRISBURG PA
17109-5004
US

IV. Provider business mailing address

891 S ARLINGTON AVE
HARRISBURG PA
17109-5004
US

V. Phone/Fax

Practice location:
  • Phone: 717-233-9093
  • Fax: 717-233-6387
Mailing address:
  • Phone: 717-233-9093
  • Fax: 717-233-6387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD044322L
License Number StatePA

VIII. Authorized Official

Name: MRS. JACQUELYN S. FRAZIER
Title or Position: BILLING SUPERVISOR
Credential:
Phone: 717-838-6462