# DUBOIS REGIONAL MEDICAL GROUP PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PENN HIGHLANDS HEALTHCARE
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1639373020
- **Legal business name:** PENN HIGHLANDS HEALTHCARE
- **Authorized official:** MR. JOHN S SUTIKA (AUTHORIZED OFFICIAL & SECRETARY)
- **Authorized official phone:** (814) 375-3385

## Contact information

- **Practice address:** 820 TURNPIKE AVE, CLEARFIELD, PA 16830-1233
- **Practice address phone:** (814) 765-2412
- **Mailing address:** 100 HOSPITAL AVE, DU BOIS, PA 15801-1440
- **Mailing address phone:** (814) 375-6566
- **Mailing address fax:** (814) 372-2848

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 06/12/2007
- **Last updated:** 03/08/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100751931 | — | PA |