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Organization
YELLOW BREECHES FAMILY PRACTICE CENTER
Active
Organization
YELLOW BREECHES FAMILY PRACTICE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD J KOVACS MD (PARTNER)
(717) 258-3274
Entity
Organization
Contact information
Practice address
1358 LUTZTOWN RD, BOILING SPRINGS, PA 17007-9302
(717) 258-3274
(717) 258-0311
Mailing address
1358 LUTZTOWN RD, BOILING SPRINGS, PA 17007-9302
(717) 258-3274
(717) 258-0311
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02483200
CAPITAL BLUE CROSS
PA
01
—
153146
MEDICARE GROUP NUMBER
PA
Enumeration date
07/08/2006
Last updated
06/16/2010
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