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General NPI Number Information
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NPI Number | 1295141331
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Entity Type | Organization
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Legal Business Name | DLP CONEMAUGH PHYSICIAN PRACTICES LLC
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Dates
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Enumeration Date | 07/09/2014
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Last Update Date | 07/09/2014
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Provider Practice Location Address
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Address Line | 6854 ROUTE 711
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City | SEWARD
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State | PA
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Zip | 15954-3121
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Country | US
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Telephone | 814-446-4032
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Fax | 814-446-4033
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Provider Business Mailing Address
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Address Line | 6854 ROUTE 711
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City | SEWARD
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State | PA
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Zip | 15954-3121
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Country | US
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Telephone | 814-446-4032
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Fax | 814-446-4033
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Authorized Official
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Title or Position | PRESIDENT
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Name | JESS N JUDY
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Credential |
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Telephone | 615-920-7000
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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 |
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