Healthcare Provider Details

I. General information

NPI: 1871800607
Provider Name (Legal Business Name): JESSICA L SOUCHET D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2010
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 GEISINGER LN
LEWISTOWN PA
17044-3400
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822-4903
US

V. Phone/Fax

Practice location:
  • Phone: 717-242-4200
  • Fax: 717-242-4237
Mailing address:
  • Phone: 717-242-4200
  • Fax: 717-242-4237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS020439
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: