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General NPI Number Information
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NPI Number | 1194196402
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Entity Type | Organization
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Legal Business Name | ST. LUKE'S PHYSICIAN GROUP INC
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Dates
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Enumeration Date | 10/13/2015
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 770 STATE RD
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City | LEHIGHTON
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State | PA
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Zip | 18235-2857
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Country | US
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Telephone | 610-377-9020
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Fax | 610-377-9784
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Provider Business Mailing Address
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Address Line | 770 STATE RD
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City | LEHIGHTON
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State | PA
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Zip | 18235-2857
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Country | US
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Telephone | 610-377-9020
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Fax | 610-377-9784
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSEPH MINAHAN
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Credential |
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Telephone | 484-526-3383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | PA
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