NPIMap

Organization Active NPI

Punxsutawney Medical Services - ENT

  • Otolaryngology Physician
  • Punxsutawney, PA
National Provider Identifier
1194854463
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD 067875L Issued in PA
Legal business name
PUNXSUTAWNEY MEDICAL SERVICES - ENT
Practice address
1464 N Main St
Suite 9
Punxsutawney, PA 15767-2609
Phone
(814) 938-2300
Fax
(814) 938-6878
NPI assigned
Mar 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Jack Sisk
Title
Chief Financial Officer
Phone
(814) 938-1882

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X MD 067875L PA Primary

Addresses

Primary practice location

1464 N Main St
Suite 9
Punxsutawney, PA 15767-2609

Mailing address

81 Hillcrest Dr
Punxsutawney, PA 15767-2605
Phone (814) 938-1450

National Provider Directory

National Provider Directory
Tax ID family
Punxsutawney Medical Services - Anesthesia9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194854463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 HILLCREST DR",
            "city": "PUNXSUTAWNEY",
            "state": "PA",
            "postal_code": "157672605",
            "telephone_number": "814-938-1450",
            "fax_number": "814-938-1885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1464 N MAIN ST",
            "address_2": "SUITE 9",
            "city": "PUNXSUTAWNEY",
            "state": "PA",
            "postal_code": "157672609",
            "telephone_number": "814-938-2300",
            "fax_number": "814-938-6878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUNXSUTAWNEY MEDICAL SERVICES - ENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SISK",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "814-938-1882",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MD 067875L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Punxsutawney, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.