Healthcare Provider Details

I. General information

NPI: 1447279807
Provider Name (Legal Business Name): JOHN LAWRENCE GINSBURG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 N 5TH ST
LEWISBURG PA
17837-1407
US

IV. Provider business mailing address

130 HOSPITAL DR
LEWISBURG PA
17837-9315
US

V. Phone/Fax

Practice location:
  • Phone: 570-523-3350
  • Fax: 570-522-0404
Mailing address:
  • Phone: 570-522-4110
  • Fax: 570-522-4120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD013692E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: