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General NPI Number Information
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NPI Number | 1447231923
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Entity Type | Organization
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Legal Business Name | LANCASTER GENERAL MEDICAL GROUP
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Dates
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Enumeration Date | 11/10/2005
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Last Update Date | 08/20/2007
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Provider Practice Location Address
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Address Line | 405 MAIN ST
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City | LANDISVILLE
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State | PA
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Zip | 17538-1812
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Country | US
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Telephone | 717-898-2413
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Fax | 717-898-9142
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Provider Business Mailing Address
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Address Line | 405 MAIN ST
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City | LANDISVILLE
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State | PA
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Zip | 17538-1812
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Country | US
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Telephone | 717-898-2413
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Fax | 717-898-9142
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEROME I GOTTLIEB
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Credential | M.D.
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Telephone | 717-544-4001
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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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