Medical Park Ear Nose & Throat LTD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

MD023535E Issued in PA

Legal business name

MEDICAL PARK EAR NOSE & THROAT LTD

Practice address

80 Medical Park Dr
Lewisburg, PA 17837-6343

Phone

(570) 523-1163

Fax

(570) 524-5737

NPI assigned

Jul 19, 2005

Organization subpart

No

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

Authorized official

Name

Dr. William B Bruce, MD

Title

Medical Doctor

Phone

(570) 523-1163

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358121600000",
    "number": "1871592055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 MEDICAL PARK DR",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178376343",
            "telephone_number": "570-523-1163",
            "fax_number": "570-524-5737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 MEDICAL PARK DR",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178376343",
            "telephone_number": "570-523-1163",
            "fax_number": "570-524-5737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL PARK EAR NOSE & THROAT LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-19",
        "last_updated": "2013-01-14",
        "status": "A",
        "authorized_official_last_name": "BRUCE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "570-523-1163",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MD023535E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007486870002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "01650001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "072467",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin McNamara, M.D.
• Allison A McOwen, DO
• Wendy Jane McTammany, PTA
• Libby Meadow, CRNP
• Heidi Mecum
• Alexis Kay Melhorn
• Dennis A Merkle, PA-C
• Linda S Messner, CRNP
• Michael R. Gildea PC
• Virginia T Michael, M.ED, LPC

• Otolaryngology Physician in Lewisburg, PA
• Providers in Lewisburg, PA by specialty
• Otolaryngology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2013; 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.