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NPI Code Detail

MEDICARE: MUNCY FAMILY PRACTICE LLC

MEDICARE: MUNCY FAMILY PRACTICE LLC
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 PhysicianOS007523EPA

General Provider Information

NPI Number : 1891245247
Entity Type Code : Organization
Provider Name (Legal Business Name) : MUNCY FAMILY PRACTICE LLC
Provider Business Mailing Address
First Line : 151 JOHN BRADY DR
Second Line : SUITE 4
City : PENNSDALE
State : PA
Zip : 17756-8401
Country : US
Telephone Number : 570-546-8255
Fax Number : 570-546-3668
Provider Business Practice Location Address
First Line : 151 JOHN BRADY DR
Second Line : SUITE 4
City : PENNSDALE
State : PA
Zip : 17756-8401
Country : US
Telephone Number : 570-546-8255
Fax Number : 570-546-3668
Authorized Official
Title or Position : PHYSICAN/OWNER
Name : JAMES F WAY JR.
Credential : D.O.
Telephone Number : 570-546-8255
Provider Enumeration Date : 10/10/2016
Last Update Date : 10/10/2016

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Directions to “MUNCY FAMILY PRACTICE LLC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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