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General NPI Number Information
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NPI Number | 1649482522
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Entity Type | Organization
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Legal Business Name | PENNSYLVANIA PHYSICIANS P C
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 12/10/2010
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Provider Practice Location Address
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Address Line | 10900 KNIGHTS RD
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City | PHILADELPHIA
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State | PA
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Zip | 19154-4210
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Country | US
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Telephone | 215-632-0693
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Fax |
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Provider Business Mailing Address
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Address Line | 10900 KNIGHTS RD
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City | PHILADELPHIA
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State | PA
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Zip | 19154-4210
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Country | US
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Telephone | 215-632-0693
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JOHN PHILIP LEICHNER
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Credential | MD
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Telephone | 215-632-0693
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD023910E
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License Number State | PA
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