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General NPI Number Information
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NPI Number | 1376523449
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Entity Type | Organization
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Legal Business Name | CORNERSTONE FAMILY HEALTH, PC
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Dates
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Enumeration Date | 01/17/2006
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Last Update Date | 11/18/2009
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Provider Practice Location Address
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Address Line | 1205 GRAMPIAN BLVD SUITE 3
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-1978
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Country | US
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Telephone | 570-326-4118
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Fax | 570-326-5533
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Provider Business Mailing Address
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Address Line | 1205 GRAMPIAN BLVD SUITE 3
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-1978
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Country | US
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Telephone | 570-326-4118
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Fax | 570-326-5533
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES REDKA
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Credential | M.D.
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Telephone | 570-326-4118
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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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