Geisinger Clinic

Organization Active NPI Neurological Surgery Physician · Danville, PA

NPI 1891746327 · NPPES record last updated Jun 27, 2008

Key facts

NPI
1891746327
Entity type
Organization (NPI type 2)
Primary specialty
Neurological Surgery Physician 207T00000X
Legal business name
GEISINGER CLINIC
Practice address
100 N Academy Ave
Danville, PA 17822
Phone
(570) 271-6211
NPI assigned
May 12, 2006
Organization subpart
No

Authorized official

Name
Kenneth Holdren
Title
Cao
Phone
(570) 271-5490

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
O20040130000518 PA Part B Supplier - Clinic/Group Practice 5395657001 Receives reassigned benefits from 5,323 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

Tax ID family
Geisinger Clinic Sunbury (275 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207T00000X Yes
Physician Assistant
Group: 193200000X MULTI-SPECIALTY GROUP
363A00000X
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363L00000X

Addresses

Primary practice location

100 N Academy Ave
Danville, PA 17822

Mailing address

100 N Academy Ave
Danville, PA 17822-3034

Other providers in Danville, PA

All providers in Danville, PA · Neurological Surgery Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.