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NPI Code Detail

MEDICARE: GEISINGER CLINIC

MEDICARE: GEISINGER CLINIC
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
1207R00000XInternal Medicine Physician
2207ZP0105XClinical Pathology/Laboratory Medicine Physician
3208000000XPediatrics Physician
42085R0202XDiagnostic Radiology Physician
5291U00000XClinical Medical LaboratoryPA
6332B00000XDurable Medical Equipment & Medical Supplies
7363A00000XPhysician Assistant
8363L00000XNurse Practitioner
9207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1114977626
Entity Type Code : Organization
Provider Name (Legal Business Name) : GEISINGER CLINIC
Provider Business Mailing Address
First Line : 100 N ACADEMY AVE
Second Line :
City : DANVILLE
State : PA
Zip : 17822-3034
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 240 MALL BLVD
Second Line :
City : BLOOMSBURG
State : PA
Zip : 17815-8306
Country : US
Telephone Number : 570-416-8250
Fax Number :
Authorized Official
Title or Position : SYSTEM DIRECTOR CREDENTIALING
Name : CINDY L MULL
Credential :
Telephone Number : 570-271-6603
Provider Enumeration Date : 05/12/2006
Last Update Date : 08/23/2022

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Directions to “GEISINGER CLINIC ” Practice Location

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