Healthcare Provider Details

I. General information

NPI: 1629043666
Provider Name (Legal Business Name): JAY A TOWNSEND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 02/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S HIGH ST
NEWVILLE PA
17241-1409
US

IV. Provider business mailing address

100 S HIGH ST
NEWVILLE PA
17241-1409
US

V. Phone/Fax

Practice location:
  • Phone: 717-776-3114
  • Fax: 717-776-6003
Mailing address:
  • Phone: 717-776-3114
  • Fax: 717-776-6003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD011039E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: