| Alfred Parker Kennedy Jr, MD | |
|
100 N Academy Ave, Danville, PA 17822-2219 | |
| (570) 214-7967 | |
| (570) 214-2800 |
| Full Name | Alfred Parker Kennedy Jr |
|---|---|
| Gender | Male |
| Speciality | Surgery - Pediatric Surgery |
| Location | 100 N Academy Ave, Danville, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821076019 | NPI | - | NPPES |
| 5440421 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2086S0120X | Surgery - Pediatric Surgery | MD38890 (Tennessee) | Secondary |
| 2086S0120X | Surgery - Pediatric Surgery | MD048614L (Pennsylvania) | Primary |
| Entity Name | Geisinger Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366493868 PECOS PAC ID: 5395657001 Enrollment ID: O20040130000518 |
| Mailing Address | Practice Location Address |
|---|---|
| Alfred Parker Kennedy Jr, MD 100 N Academy Ave, Danville, PA 17822-4903 Ph: (570) 271-6144 | Alfred Parker Kennedy Jr, MD 100 N Academy Ave, Danville, PA 17822-2219 Ph: (570) 214-7967 |
Dr. Tara Jean Loux, MD Surgery Medicare: Medicare Enrolled Practice Location: 100 N Academy Ave, Danville, PA 17822 Phone: 570-214-7967 | |
Christie Buonpane, Surgery Medicare: Medicare Enrolled Practice Location: 100 N Academy Ave, Danville, PA 17822 Phone: 570-271-6211 | |
Gabriel Mekel Nakhal, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 100 N Academy Ave, Danville, PA 17822 Phone: 570-271-6361 | |
Jonathan Stuart Weyerbacher, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 100 North Academy Ave, Danville, PA 17822 Phone: 570-271-6363 Fax: 570-271-9208 | |
Alexandra Maningat, Surgery Medicare: Medicare Enrolled Practice Location: 100 N Academy Ave # Mc27-70, Danville, PA 17822 Phone: 570-214-2403 | |
Nicolas Patrick Cassata, MD Surgery Medicare: Medicare Enrolled Practice Location: 1000 E Mountain Drive, Danville, PA 17822 Phone: 570-271-6361 Fax: 570-271-5785 | |
Anthony John Georges, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 100 N Academy Ave, Danville, PA 17822 Phone: 570-214-7967 |