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

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
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 (165 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
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 Doing business as

Other providers in Lehighton, PA

All providers in Lehighton, PA · Internal Medicine Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.