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General NPI Number Information
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NPI Number | 1891724621
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Entity Type | Organization
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Legal Business Name | JUNIATA VALLEY GASTROENTEROLOGY ASSOCIATES, PC
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Dates
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Enumeration Date | 07/02/2006
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Last Update Date | 06/20/2011
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Provider Practice Location Address
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Address Line | 310 ELECTRIC AVE STE 100
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City | LEWISTOWN
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State | PA
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Zip | 17044-1369
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Country | US
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Telephone | 717-242-2531
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Fax | 717-242-1028
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Provider Business Mailing Address
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Address Line | 310 ELECTRIC AVE STE 100
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City | LEWISTOWN
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State | PA
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Zip | 17044-1369
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Country | US
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Telephone | 717-242-2531
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Fax | 717-242-1028
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHARLES W EVERHART JR.
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Credential | M.D.
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Telephone | 717-242-2531
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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