Fayette Physician Network
Organization Active NPI Physician Assistant · Grindstone, PA
NPI 1710437348 · NPPES record last updated Oct 6, 2016
Key facts
- NPI
- 1710437348
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physician Assistant 363A00000X
- License
- MA058454 (PA)
- Legal business name
- FAYETTE PHYSICIAN NETWORK
- Practice address
- 111 Roberts Rd
Grindstone, PA 15442-1105 - Phone
- (724) 785-2286
- NPI assigned
- Oct 6, 2016
- Organization subpart
- No
Authorized official
- Name
- Dorothy Knight
- Title
- Executive Administrator
- Phone
- (724) 430-8035
Corporate family (same tax ID) 12
National Provider Directory
- Tax ID family
- Fayette Phys Network Inc
Locations
111 Roberts Rd
Grindstone, PA 15442
Phone (724) 785-2286
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant |
363A00000X | MA058454 | PA | Yes |
Addresses
Primary practice location
111 Roberts Rd
Grindstone, PA 15442-1105
Mailing address
PO Box 524
Roscoe, PA 15477-0524
Phone (724) 678-9772
Other providers in Grindstone, PA
- Rebecca Lynn Baumiller
- Linda Marie Burstynowicz
- Samantha Q Bush
- Delaphinas Caregiving Services LLC
- Fayette Medical Associates Inc
- Fayette Physician Network Inc
- Fayette Physician Network Inc
- Adam Guzik
- Renee Lynn Kurdilla
- Kevin Michael Lotman
All providers in Grindstone, PA · Physician Assistant in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.