Healthcare Provider Details
I. General information
NPI: 1841678489
Provider Name (Legal Business Name): DONALD E. GARRISON D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/15/2015
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
252 S 4TH ST
LEBANON PA
17042-6111
US
IV. Provider business mailing address
1799 QUENTIN RD
LEBANON PA
17042-7492
US
V. Phone/Fax
- Phone: 717-270-7500
- Fax:
- Phone: 707-508-8172
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 101-321 |
| License Number State | WI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | O-1128 |
| License Number State | ID |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 79888 |
| License Number State | MN |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 34.015801 |
| License Number State | OH |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | OT016553 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: