| Susquehanna Health Medical Group | |
|
610 High St Lock Haven PA 17745-3031 | |
| (570) 748-1260 | |
| (570) 748-1261 |
| Full Name | Susquehanna Health Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 610 High St, Lock Haven, Pennsylvania |
| Authorized Official Name and Position | Melissa Davis (VP/COO) |
| Authorized Official Contact | 5703207696 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susquehanna Health Medical Group 1201 Grampian Blvd Williamsport PA 17701-1900 Ph: () - | Susquehanna Health Medical Group 610 High St Lock Haven PA 17745-3031 Ph: (570) 748-1260 |
| NPI Number | 1972548337 |
|---|---|
| Provider Enumeration Date | 06/19/2006 |
| Last Update Date | 10/19/2015 |
| Medicare PECOS PAC ID | 2264336460 |
|---|---|
| Medicare Enrollment ID | O20040426001371 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972548337 | NPI | - | NPPES |
| 0017300760152 | Medicaid | PA | |
| 804540 | Other | PA | HIGHMARK BLUE SHIELD |
| Provider Name | Carrie A Timko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447228978 PECOS PAC ID: 1355476821 Enrollment ID: I20100323000424 |
| Provider Name | Dennis Probst |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598791741 PECOS PAC ID: 1153312186 Enrollment ID: I20110211000771 |
| Provider Name | Sarah L Mcelroy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376708487 PECOS PAC ID: 1850561945 Enrollment ID: I20110829000248 |
| Provider Name | John Robert Hunter |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1184963662 PECOS PAC ID: 0042444804 Enrollment ID: I20171103000147 |
| Provider Name | David Luo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164957379 PECOS PAC ID: 4284971268 Enrollment ID: I20200909002673 |
| Provider Name | Katie Lynn Thomke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063091692 PECOS PAC ID: 0941618086 Enrollment ID: I20210409000857 |
| Provider Name | Marcus Daniel Powers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982195442 PECOS PAC ID: 9335545060 Enrollment ID: I20210907000108 |
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