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NPI Code Detail

MEDICARE: DR. JOHN E PRIOR D.O.

MEDICARE: DR. JOHN E PRIOR D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RN0300XNephrology Physician05-115423-LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2077484OTHERPAFIRST PRIORITY
34101986OTHERPAAETNA

General Provider Information

NPI Number : 1053315085
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN E PRIOR D.O.
Provider Business Mailing Address
First Line : 802 JEFFERSON AVE
Second Line :
City : SCRANTON
State : PA
Zip : 18510-1038
Country : US
Telephone Number : 570-348-0360
Fax Number : 570-348-0362
Provider Business Practice Location Address
First Line : 802 JEFFERSON AVE
Second Line :
City : SCRANTON
State : PA
Zip : 18510-1038
Country : US
Telephone Number : 570-348-0360
Fax Number : 570-348-0362
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2005
Last Update Date : 04/23/2014

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