Healthcare Provider Details

I. General information

NPI: 1760453831
Provider Name (Legal Business Name): FRANCIS PATRICK MOHAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 01/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 OAK GROVE RD SUITE 1
PINE GROVE PA
17963-1226
US

IV. Provider business mailing address

8 OAK GROVE RD SUITE 1
PINE GROVE PA
17963-1226
US

V. Phone/Fax

Practice location:
  • Phone: 570-345-3321
  • Fax: 570-345-6470
Mailing address:
  • Phone: 570-345-3321
  • Fax: 570-345-6470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD040308E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: