| Susquehanna Physician Services | |
|
699 Rural Ave Suite 302 Williamsport PA 17701-3250 | |
| (570) 321-3772 | |
| (570) 321-3773 |
| Full Name | Susquehanna Physician Services |
|---|---|
| Speciality | Family Medicine |
| Location | 699 Rural Ave, Williamsport, Pennsylvania |
| Authorized Official Name and Position | Charles Santangelo (EXECUTIVE VP CFO) |
| Authorized Official Contact | 5703213171 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Susquehanna Physician Services 1201 Grampian Blvd Po Box 3127 Williamsport PA 17701-0127 Ph: () - | Susquehanna Physician Services 699 Rural Ave Suite 302 Williamsport PA 17701-3250 Ph: (570) 321-3772 |
| NPI Number | 1871769760 |
|---|---|
| Provider Enumeration Date | 05/01/2008 |
| Last Update Date | 05/21/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871769760 | NPI | - | NPPES |
| 0017300760188 | Medicaid | PA | |
| 2062154 | Other | PA | HIGHMARK BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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