Healthcare Provider Details

I. General information

NPI: 1376075721
Provider Name (Legal Business Name): ERICH HUFNAGEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 09/13/2021
Certification Date: 09/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W 4TH ST
WILLIAMSPORT PA
17701-5895
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822-4903
US

V. Phone/Fax

Practice location:
  • Phone: 570-321-0880
  • Fax: 570-601-1465
Mailing address:
  • Phone: 570-271-6144
  • Fax: 570-271-6578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD473335
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: