NPIMap

Organization Active NPI

Wayne Surgical Associates PC

  • Surgery Physician
  • Honesdale, PA
National Provider Identifier
1871781518
Registry record updated Jun 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD016938E Issued in PA
Legal business name
WAYNE SURGICAL ASSOCIATES PC
Practice address
507 High St
Honesdale, PA 18431-1733
Phone
(570) 253-2620
Fax
(570) 253-2651
NPI assigned
Oct 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2011

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

Authorized official

Name
Dr. George W Tietjen, MD
Title
Owner
Phone
(570) 253-2620

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X MD016938E PA Primary

Addresses

Primary practice location

507 High St
Honesdale, PA 18431-1733

Mailing address

507 High St
Honesdale, PA 18431-1733
Phone (570) 253-2620

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308528000000",
    "number": "1871781518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 HIGH ST",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184311733",
            "telephone_number": "570-253-2620",
            "fax_number": "570-253-2651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 HIGH ST",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "184311733",
            "telephone_number": "570-253-2620",
            "fax_number": "570-253-2651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE SURGICAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-09",
        "last_updated": "2011-06-20",
        "status": "A",
        "authorized_official_last_name": "TIETJEN",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-253-2620",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD016938E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honesdale, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2011; 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.