| Dr Jonathan L Spaulding, DO | |
|
965 Shamrock Ln, Corry, PA 16407-9121 | |
| (814) 664-4641 | |
| (814) 663-9900 |
| Full Name | Dr Jonathan L Spaulding |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 965 Shamrock Ln, Corry, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912975194 | NPI | - | NPPES |
| 0016621180015 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 34007573 (Ohio) | Secondary |
| 207P00000X | Emergency Medicine | O5009254C (Pennsylvania) | Primary |
| Entity Name | Corry Memorial Hospital Association |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1841268877 PECOS PAC ID: 3971581174 Enrollment ID: O20061104000588 |
| Entity Name | Corry Memorial Hospital Association |
|---|---|
| Entity Type | Part B Supplier - Hospital Department(s) |
| Entity Identifiers | NPI Number: 1255788014 PECOS PAC ID: 3971581174 Enrollment ID: O20160816000171 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jonathan L Spaulding, DO 1 Lecom Pl, Erie, PA 16505-2571 Ph: (814) 868-2507 | Dr Jonathan L Spaulding, DO 965 Shamrock Ln, Corry, PA 16407-9121 Ph: (814) 664-4641 |
Dr. Michael Antoon, DO Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 612 W Smith St, Corry, PA 16407 Phone: 180-083-4486 |
Michael Robert Grossman, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 965 Shamrock Ln, Corry, PA 16407 Phone: 814-664-4641 Fax: 814-664-8799 |