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General NPI Number Information
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NPI Number | 1205035276
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Entity Type | Organization
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Legal Business Name | MID-STATE MEDICAL SERVICES, INC
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 07/11/2007
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Provider Practice Location Address
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Address Line | 601 N FRONT ST
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City | PHILIPSBURG
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State | PA
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Zip | 16866-2303
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Country | US
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Telephone | 814-342-7399
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Fax |
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Provider Business Mailing Address
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Address Line | 601 N FRONT ST
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City | PHILIPSBURG
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State | PA
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Zip | 16866-2303
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Country | US
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Telephone | 814-342-7399
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Fax |
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | LAWRENCE G ADAMS
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Credential |
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Telephone | 814-342-7399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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