MEDICARE: JOHN A SCHROTH PA

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
1	363AM0700X	Medical Physician Assistant	MA000570L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MA000570L	OTHER	PA	STATE LICENSE

General Provider Information

NPI Number	:	1154406924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN A SCHROTH PA

Provider Business Mailing Address
First Line	:	1301 MAPLE AVE
Second Line	:
City	:	HOLLIDAYSBURG
State	:	PA
Zip	:	16648-1123
Country	:	US
Telephone Number	:	814-696-2993
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 HOSPITAL DR
Second Line	:
City	:	TYRONE
State	:	PA
Zip	:	16686-1810
Country	:	US
Telephone Number	:	814-684-6374
Fax Number	:	814-684-6320

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	07/08/2007

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Directions to “ JOHN A SCHROTH PA” Practice Location

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