Healthcare Provider Details

I. General information

NPI: 1710942776
Provider Name (Legal Business Name): THE MILTON S. HERSHEY MEDICAL CENTER PHYSICIAN GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 UNIVERSITY DR
HERSHEY PA
17033-2360
US

IV. Provider business mailing address

PO BOX 854 MC A410
HERSHEY PA
17033-0854
US

V. Phone/Fax

Practice location:
  • Phone: 800-243-1455
  • Fax:
Mailing address:
  • Phone: 717-531-5995
  • Fax: 717-531-6934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DONALD MCKENNA
Title or Position: PRESIDENT
Credential:
Phone: 717-531-3979