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Organization
KENNETH R DURRWACHTER MD PC
Active
Organization
KENNETH R DURRWACHTER MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH R DURRWACHTER MD (OWNER)
(570) 601-6230
Entity
Organization
Contact information
Practice address
1705 WARREN AVE, SUITE 208, WILLIAMSPORT, PA 17701-2647
(570) 601-6230
(570) 601-6232
Mailing address
1705 WARREN AVE, SUITE 208, WILLIAMSPORT, PA 17701-2647
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD045039L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1016212250001
—
PA
01
—
1849658
HIGHMARK BLUE SHIELD
PA
01
—
222566
FIRST PRIORITY HEALTH
PA
01
—
C253
GEISINGER HEALTH PLAN
PA
Enumeration date
05/19/2006
Last updated
01/13/2010
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