# SUSQUEHANNA PHYSICIAN SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245835388
- **Authorized official:** MELISSA DAVIS (VP/COO)
- **Authorized official phone:** (570) 326-8544

## Contact information

- **Practice address:** 1201 GRAMPIAN BLVD STE 2F, WILLIAMSPORT, PA 17701-1965
- **Practice address phone:** (570) 321-2020
- **Practice address fax:** (570) 320-7599
- **Mailing address:** 1201 GRAMPIAN BLVD, WILLIAMSPORT, PA 17701-1900

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 12/04/2020
- **Last updated:** 12/04/2020