Tunkhannock Clinic Company LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

TUNKHANNOCK CLINIC COMPANY LLC

Practice address

5950 Sr 6
Tunkhannock, PA 18657-7905

Phone

(570) 996-1134

Fax

(570) 836-0136

NPI assigned

Mar 30, 2011

Last updated

Oct 18, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Debbie T Brewer

Title

Director

Phone

(877) 892-9813

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318896000000",
    "number": "1891084810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 MERIDIAN BLVD",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370676325",
            "telephone_number": "877-309-5312",
            "fax_number": "615-465-2877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5950 SR 6",
            "city": "TUNKHANNOCK",
            "state": "PA",
            "postal_code": "186577905",
            "telephone_number": "570-996-1134",
            "fax_number": "570-836-0136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUNKHANNOCK CLINIC COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-30",
        "last_updated": "2011-10-18",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "877-892-9813"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102583209 0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Tunkhannock, PA
• Providers in Tunkhannock, PA by specialty
• Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.