| Dallas Family Practice, L.l.c. | |
|
16 Church St Dallas PA 18612-1136 | |
| (570) 675-2111 | |
| (570) 675-6545 |
| Full Name | Dallas Family Practice, L.l.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 16 Church St, Dallas, Pennsylvania |
| Authorized Official Name and Position | Jane E Durkin (PRESIDENT) |
| Authorized Official Contact | 5706752111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dallas Family Practice, L.l.c. 16 Church St Dallas PA 18612-1136 Ph: (570) 675-2111 | Dallas Family Practice, L.l.c. 16 Church St Dallas PA 18612-1136 Ph: (570) 675-2111 |
| NPI Number | 1124087184 |
|---|---|
| Provider Enumeration Date | 03/20/2006 |
| Last Update Date | 01/25/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124087184 | NPI | - | NPPES |
| 001823531-0002 | Medicaid | PA | |
| E160 | Other | PA | GEISINGER HEALTH PLAN |
| 78201 | Other | PA | MED PLUS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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Geisinger Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 16 Church St, Dallas, PA 18612 Phone: 570-675-2111 Fax: 570-675-6545 | |
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