# UNIVERSITY OF PENN-PA TRAUMA

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

## Provider details

- **NPI number:** 1275640971
- **Authorized official:** ELIZABETH JOHNSTON (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (215) 662-7583

## Contact information

- **Practice address:** 3400 SPRUCE ST, 2 DULLES, PHILADELPHIA, PA 19104-4206
- **Practice address phone:** (215) 662-7320
- **Practice address fax:** (215) 349-5917
- **Mailing address:** 3624 MARKET ST, SUITE 560 W, PHILADELPHIA, PA 19104-2614
- **Mailing address phone:** (215) 662-2286
- **Mailing address fax:** (215) 615-0500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | — | PA | — |
| 2086S0102X | Surgical Critical Care Physician | — | PA | Yes |

## Other

- **Enumeration date:** 08/25/2006
- **Last updated:** 06/10/2011