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Organization
PORT CITY FAMILY MEDICINE P.C. INC
Active
Organization
PORT CITY FAMILY MEDICINE P.C. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CORLISS ADAM VARNUM M.D. (PRESIDENT)
(315) 343-6974
Entity
Organization
Contact information
Practice address
33 E SCHUYLER ST, OSWEGO, NY 13126-1161
(315) 343-6974
(315) 342-3625
Mailing address
33 E SCHUYLER ST, OSWEGO, NY 13126-1161
(315) 343-6974
(315) 342-3625
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00964989
—
NY
Enumeration date
09/27/2006
Last updated
03/15/2019
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