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Organization
LANCASTER GENERAL MEDICAL GROUP
Active
Organization
LANCASTER GENERAL MEDICAL GROUP
Active
Other names
Landisville Family Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEROME I GOTTLIEB M.D. (PRESIDENT)
(717) 544-4001
Entity
Organization
Contact information
Practice address
405 MAIN ST, LANDISVILLE, PA 17538-1812
(717) 898-2413
(717) 898-9142
Mailing address
405 MAIN ST, LANDISVILLE, PA 17538-1812
(717) 898-2413
(717) 898-9142
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007327490136
—
PA
01
—
1540390
GATEWAY HEALTH PLAN
PA
01
—
1648901
HIGHMARK BLUE SHIELD
PA
01
—
3974095
AETNA HMO
PA
01
—
50041081
CAPITAL BLUE CROSS
PA
01
—
676677
AETNA CAP OFFICE#
PA
01
—
7315670
AETNA NON-HMO
PA
01
—
CN7614
RAILROAD MEDICARE
PA
01
—
S1QE
GEISINGER HEALTH PLAN
PA
Enumeration date
11/10/2005
Last updated
08/20/2007
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