# IVYLAND MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720057474
- **Authorized official:** DR. BRAD PADDOCK MD (OWNER)
- **Authorized official phone:** (215) 442-9929

## Contact information

- **Practice address:** 1035 W BRISTOL RD, SUITE B, WARMINSTER, PA 18974-1009
- **Practice address phone:** (215) 442-9929
- **Practice address fax:** (215) 442-9927
- **Mailing address:** 1035 W BRISTOL RD, SUITE B, WARMINSTER, PA 18974-1009
- **Mailing address phone:** (215) 442-9929
- **Mailing address fax:** (215) 442-9927

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD071701L | PA | Yes |

## Other

- **Enumeration date:** 03/15/2006
- **Last updated:** 02/17/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0078015690002 | — | PA |
| 01 | — | 2090073001 | INDEPENDENCE BLUE CROSS | PA |
| 01 | — | 2864291 | AETNA/US HEALTHCARE | PA |
| 01 | — | 30004076 | KEYSTONE MERCY HEALTHPLAN | PA |
| 01 | — | IV1401548 | BLUE SHIELD OF PA | PA |