Healthcare Provider Details

I. General information

NPI: 1659959609
Provider Name (Legal Business Name): EXCELA HEALTH PHYSICIAN PRACTICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 03/31/2021
Certification Date: 03/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8791 BARNES LAKE RD STE 101
NORTH HUNTINGDON PA
15642-3176
US

IV. Provider business mailing address

8791 BARNES LAKE RD STE 101
NORTH HUNTINGDON PA
15642-3176
US

V. Phone/Fax

Practice location:
  • Phone: 724-864-9400
  • Fax: 724-864-8044
Mailing address:
  • Phone: 724-864-9400
  • Fax: 724-864-8044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RENEE M VARNEY
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 724-850-6933