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Organization
WJO INC.
Active
Organization
WJO INC.
Active
Other names
South Philly Family Practice and Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINE MCMANUS (DIRECTOR OF HUMAN RESOURCES)
(215) 757-0465
Entity
Organization
Contact information
Practice address
1800 JACKSON ST, PHILA, PA 19145-3712
(215) 826-8050
(215) 826-8053
Mailing address
424 MILL ST, BRISTOL, PA 19007-4813
(215) 826-8050
(215) 826-8053
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1675135
HIGHMARK
PA
01
—
2351050000
IBC
PA
Enumeration date
05/25/2006
Last updated
09/30/2010
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