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NPI Code Detail

MEDICARE: DR. JEROME LEE KORINCHAK M.D.

MEDICARE:  DR. JEROME LEE KORINCHAK  M.D.
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
1207Q00000XFamily Medicine PhysicianMD025540EPA

General Provider Information

NPI Number : 1700895976
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEROME LEE KORINCHAK M.D.
Provider Business Mailing Address
First Line : 1470 MIDDLE RD
Second Line :
City : LEWISTOWN
State : PA
Zip : 17044-3501
Country : US
Telephone Number : 717-250-4260
Fax Number : 570-372-5766
Provider Business Practice Location Address
First Line : 1000 ROUTE 522
Second Line :
City : SELINSGROVE
State : PA
Zip : 17870-8707
Country : US
Telephone Number : 570-372-5690
Fax Number : 570-372-5766
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2006
Last Update Date : 05/29/2008

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Directions to “ DR. JEROME LEE KORINCHAK M.D.” Practice Location

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