St. Luke'S Physician Group, Inc.
Organization Active NPI Internal Medicine Physician · Lehighton, PA
NPI 1861597213 · NPPES record last updated Apr 16, 2010
Key facts
- NPI
- 1861597213
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- ST. LUKE'S PHYSICIAN GROUP, INC.
- Practice address
- 204 State Rd
Lehighton, PA 18235-2827 - Phone
- (610) 377-6225
- Fax
- (610) 377-5991
- NPI assigned
- Sep 13, 2006
- Organization subpart
- No
Authorized official
- Name
- Dean W Evans
- Title
- President
- Phone
- (610) 954-4991
Corporate family (same tax ID) 24
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040226000062 | PA | Part B Supplier - Clinic/Group Practice | 6709798333 |
Receives reassigned benefits from 3,523 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Upper Bucks Emergency M
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | PA | Yes |
Addresses
Primary practice location
204 State Rd
Lehighton, PA 18235-2827
Mailing address
623 E Broad St
2ND FLR
Bethlehem, PA 18018-6332
Phone (610) 954-6048
Other names
- FRANKLIN TOWNSHIP MEDICAL ASSOCIATES
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All providers in Lehighton, PA · Internal 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 Apr 16, 2010. 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.