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Good Samaritan Physician Services

Organization Active NPI Vascular Surgery Physician · Lebanon, PA

NPI 1063963585 · NPPES record last updated Oct 19, 2016

Key facts

NPI
1063963585
Entity type
Organization (NPI type 2)
Primary specialty
Vascular Surgery Physician 2086S0129X
Legal business name
GOOD SAMARITAN PHYSICIAN SERVICES
Practice address
4TH and Walnut Streets
2NS Floor
Lebanon, PA 17042
Phone
(717) 270-3751
Fax
(717) 270-3754
NPI assigned
Oct 19, 2016
Organization subpart
No

Authorized official

Name
Kathleen S Martin
Title
Manager
Phone
(717) 270-3821

Corporate family (same tax ID) 9

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Good Samaritan Physician Services (10 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 2086S0129X Yes

Addresses

Primary practice location

4TH and Walnut Streets
2NS Floor
Lebanon, PA 17042

Mailing address

PO Box 300
Lebanon, PA 17042-0300
Phone (717) 270-3751

Other names

  • WellSpan Vascular Surgery Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 19, 2016.

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476835200000",
    "number": "1063963585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 300",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170420300",
            "telephone_number": "717-270-3751",
            "fax_number": "717-270-3754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4TH AND WALNUT STREETS",
            "address_2": "2NS FLOOR",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "17042",
            "telephone_number": "717-270-3751",
            "fax_number": "717-270-3754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SAMARITAN PHYSICIAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-19",
        "last_updated": "2016-10-19",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "717-270-3821"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WellSpan Vascular Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lebanon, PA

All providers in Lebanon, PA · Vascular Surgery Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.