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NPI Code Detail

MEDICARE: EMERGENCY HEALTH SERVICES ASSOCIATES, P.A.

MEDICARE: EMERGENCY HEALTH SERVICES ASSOCIATES, P.A.
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
1207P00000XEmergency Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10036MGOTHERTXBLUE SHIELD

General Provider Information

NPI Number : 1225088479
Entity Type Code : Organization
Provider Name (Legal Business Name) : EMERGENCY HEALTH SERVICES ASSOCIATES, P.A.
Provider Business Mailing Address
First Line : PO BOX 7339
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19101-7339
Country : US
Telephone Number : 800-355-0808
Fax Number : 214-712-2444
Provider Business Practice Location Address
First Line : 3080 COLLEGE ST
Second Line :
City : BEAUMONT
State : TX
Zip : 77701-4606
Country : US
Telephone Number : 409-212-6600
Fax Number : 409-212-6601
Authorized Official
Title or Position : PRESIDENT
Name : DR. DIGHTON PACKARD
Credential : MD
Telephone Number : 214-712-2000
Provider Enumeration Date : 05/10/2006
Last Update Date : 04/20/2008

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