Fayette Physician Network Inc
Organization Active NPI Family Medicine Physician · Smithfield, PA
NPI 1588066765 · NPPES record last updated Sep 19, 2014
Key facts
- NPI
- 1588066765
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- FAYETTE PHYSICIAN NETWORK INC
- Practice address
- 25 Main St
Smithfield, PA 15478-8943 - Phone
- (724) 569-1420
- Fax
- (724) 569-5209
- NPI assigned
- Sep 19, 2014
- Organization subpart
- No
Authorized official
- Name
- Mark Ehalt
- Title
- Sr.Director
- Phone
- (412) 647-0943
Other NPIs on the same Medicare enrollment 8
Practitioners 12
-
Carson Brooke Adams, M.D.
-
Ashley Marie Ludwig, CRNP
-
Dean Watzman, MD
-
Mitchell West, DO
-
Abhishek Freyer, M.D.
-
Daniel Kowalsky, M.D.
-
Gary Richard Marree Jr., CRNA
-
Beverly J Ricker, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20141211000851 | PA | Part B Supplier - Clinic/Group Practice | 3375865819 |
Receives reassigned benefits from 518 practitioners 8 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Waynesburg, PA; Uniontown, PA; Pittsburgh, PA; Perryopolis, PA; Connellsville, PA; Carmichaels, PA; Brownsville, PA; Belle Vernon, PA… |
National Provider Directory
Locations
25 Main St
Smithfield, PA 15478
Phone (724) 569-1420
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
25 Main St
Smithfield, PA 15478-8943
Mailing address
25 Main St
Smithfield, PA 15478-8943
Phone (724) 569-1420
Other names
- FPN Smithfield
Other providers in Smithfield, PA
- Darlene Friend Counseling & Consultation LLC
- David C. Seitz DDS PC
- Aaron Duane Early
- Robert S English Jr.
- Fayette Medical Associates Inc
- Fayette Physicians Network Inc
- Jeffrey Glenn Freeman
- Darlene Marie Friend
- Nathan T Glass
- Marcy Jo Goisse
All providers in Smithfield, PA · Family Medicine Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.