| Portersville Family Practice Pllc | |
|
105 Adams Lane Portersville PA 16051 | |
| (724) 368-4118 | |
| (724) 368-4117 |
| Full Name | Portersville Family Practice Pllc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 105 Adams Lane, Portersville, Pennsylvania |
| Authorized Official Name and Position | Cory R Wilhite (OWNER) |
| Authorized Official Contact | 7243684118 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Portersville Family Practice Pllc 120 Adams Ln Portersville PA 16051-2419 Ph: (724) 368-4118 | Portersville Family Practice Pllc 105 Adams Lane Portersville PA 16051 Ph: (724) 368-4118 |
| NPI Number | 1164939138 |
|---|---|
| Provider Enumeration Date | 12/29/2017 |
| Last Update Date | 05/10/2022 |
| Medicare PECOS PAC ID | 8729340765 |
|---|---|
| Medicare Enrollment ID | O20180403000330 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164939138 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
| Provider Name | David F Simmons |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1831321157 PECOS PAC ID: 3678767217 Enrollment ID: I20101028000097 |
| Provider Name | Cory R Wilhite |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316215064 PECOS PAC ID: 1850568213 Enrollment ID: I20120125000752 |