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Organization
WEST CORNWALL FAMILY PRACTICE, P.C.
Active
Organization
WEST CORNWALL FAMILY PRACTICE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL L BISHOP (OFFICE MANAGER)
(717) 279-7303
Entity
Organization
Contact information
Practice address
101 FAIRVIEW CIR, LEBANON, PA 17042-9581
(717) 279-7303
(717) 279-7471
Mailing address
101 FAIRVIEW CIR, LEBANON, PA 17042-9581
(717) 279-7303
(717) 279-7471
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03202300
CAPITAL BLUE CROSS
PA
01
—
1519902
GATEWAY
PA
01
—
1583098
PA BLUE SHIELD
PA
Enumeration date
04/04/2006
Last updated
07/21/2022
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