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NPI Code Detail

MEDICARE: GEISINGER ORTHOPAEDICS CENTRAL ROAD, A SERVICE OF GMC

MEDICARE: GEISINGER ORTHOPAEDICS CENTRAL ROAD, A SERVICE OF GMC
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
12085R0202XDiagnostic Radiology Physician
2207X00000XOrthopaedic Surgery Physician

General Provider Information

NPI Number : 1659762862
Entity Type Code : Organization
Provider Name (Legal Business Name) : GEISINGER ORTHOPAEDICS CENTRAL ROAD, A SERVICE OF GMC
Provider Business Mailing Address
First Line : 100 N ACADEMY AVE
Second Line :
City : DANVILLE
State : PA
Zip : 17822-4903
Country : US
Telephone Number : 570-271-6144
Fax Number : 570-271-6578
Provider Business Practice Location Address
First Line : 480 CENTRAL RD
Second Line :
City : BLOOMSBURG
State : PA
Zip : 17815-3121
Country : US
Telephone Number : 570-387-6150
Fax Number : 570-387-6185
Authorized Official
Title or Position : DIRECTOR
Name : MRS. CINDY L MULL
Credential :
Telephone Number : 570-271-6144
Provider Enumeration Date : 02/10/2015
Last Update Date : 02/10/2015

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