Healthcare Provider Details

I. General information

NPI: 1326439803
Provider Name (Legal Business Name): NASON PHYSICIAN PRACTICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2015
Last Update Date: 10/19/2024
Certification Date: 10/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 HILLCREST DR
ROARING SPRING PA
16673-1211
US

IV. Provider business mailing address

105 HILLCREST DR
ROARING SPRING PA
16673-1211
US

V. Phone/Fax

Practice location:
  • Phone: 814-224-2555
  • Fax: 814-224-4704
Mailing address:
  • Phone: 814-224-2555
  • Fax: 814-224-4704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: CHARLOTTE LAWRENCE
Title or Position: SECRETARY
Credential:
Phone: 615-920-7000