Healthcare Provider Details

I. General information

NPI: 1083134282
Provider Name (Legal Business Name): PINNACLE HEALTH REGIONAL PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2017
Last Update Date: 06/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1535 HIGHLANDS DR STE 300
LITITZ PA
17543-7681
US

IV. Provider business mailing address

409 S 2ND ST STE 2F
HARRISBURG PA
17104-1612
US

V. Phone/Fax

Practice location:
  • Phone: 717-625-3509
  • Fax: 717-625-4258
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: CHRISTOPHER P. MARKLEY
Title or Position: SR VP, STRAT SVCS/GEN COUNSEL
Credential:
Phone: 717-231-8210