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Organization
NORTHERN LANCASTER COUNTY MEDICAL GROUP
Active
Organization
NORTHERN LANCASTER COUNTY MEDICAL GROUP
Active
Other names
WellSpan Family Health - Leacock
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES DAVID NOLL DO (VICE PRESIDENT)
(717) 859-5161
Entity
Organization
Contact information
Practice address
3413 HARVEST DR, GORDONVILLE, PA 17529-9586
(717) 768-7141
(717) 768-3528
Mailing address
4131 OREGON PIKE, SUITE C, EPHRATA, PA 17522-9550
(717) 859-5161
(717) 859-5169
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD007574E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013977730025
—
PA
Enumeration date
07/20/2007
Last updated
05/05/2015
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