Healthcare Provider Details

I. General information

NPI: 1588614358
Provider Name (Legal Business Name): GEISINGER CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 02/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E MOUNTAIN DR
WILKES BARRE PA
18711
US

IV. Provider business mailing address

100 N ACEDEMY AVE
DANVILLE PA
17822-3034
US

V. Phone/Fax

Practice location:
  • Phone: 570-826-7300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: CINDY MULL
Title or Position: DIRECTOR
Credential:
Phone: 570-271-6144