| Jeffersonville Internal Medicine, P.c. | |
|
1550 W Main St Jeffersonville PA 19403-3228 | |
| (610) 635-1712 | |
| (610) 635-1716 |
| Full Name | Jeffersonville Internal Medicine, P.c. |
|---|---|
| Speciality | General Practice |
| Location | 1550 W Main St, Jeffersonville, Pennsylvania |
| Authorized Official Name and Position | Michael Conrad Roman (PRESIDENT) |
| Authorized Official Contact | 6106351712 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffersonville Internal Medicine, P.c. 1550 W Main St Jeffersonville PA 19403-3228 Ph: (610) 635-1712 | Jeffersonville Internal Medicine, P.c. 1550 W Main St Jeffersonville PA 19403-3228 Ph: (610) 635-1712 |
| NPI Number | 1831131564 |
|---|---|
| Provider Enumeration Date | 06/10/2006 |
| Last Update Date | 09/11/2025 |
| Medicare PECOS PAC ID | 1355311218 |
|---|---|
| Medicare Enrollment ID | O20040728000714 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831131564 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | OS009124L (Pennsylvania) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Michael C Roman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073576849 PECOS PAC ID: 9335119296 Enrollment ID: I20040729000071 |
Fornance Physician Services, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1550 W Main St, Jeffersonville, PA 19403 Phone: 610-635-1712 Fax: 610-635-1716 |