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General NPI Number Information
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NPI Number | 1033164702
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Entity Type | Organization
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Legal Business Name | SHIPPENSBURG FAMILY PRACTICE, LTD
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 46 WALNUT BOTTOM RD
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City | SHIPPENSBURG
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State | PA
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Zip | 17257-8219
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Country | US
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Telephone | 717-530-5117
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Fax | 717-262-4593
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Provider Business Mailing Address
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Address Line | 46 WALNUT BOTTOM RD
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City | SHIPPENSBURG
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State | PA
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Zip | 17257-8219
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Country | US
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Telephone | 717-530-5117
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Fax | 717-262-4593
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MARGERY ANN GORDON
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Credential | DO
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Telephone | 717-530-5117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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