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Organization
WILKES-BARRE ACADEMIC MEDICINE LLC
Active
Organization
WILKES-BARRE ACADEMIC MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES P WRIGHT (SENIOR DIRECTOR)
(615) 465-7587
Entity
Organization
Contact information
Practice address
2 SHARPE ST, KINGSTON, PA 18704-3715
(570) 552-8900
Mailing address
4000 MERIDIAN BLVD, FRANKLIN, TN 37067-6325
(615) 465-7000
(615) 465-3007
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207VM0101X
Maternal & Fetal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
208M00000X
Hospitalist Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00002101685
BLUE SHIELD
PA
05
—
102288960-0001
—
PA
Enumeration date
03/13/2009
Last updated
05/14/2014
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