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Organization
GREAT LAKES PHYSICIAN PRACTICE PC
Active
Organization
GREAT LAKES PHYSICIAN PRACTICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA DEVLIN (SR.DIRECTOR)
(412) 432-7469
Entity
Organization
Contact information
Practice address
15 S MAIN ST, JAMESTOWN, NY 14701-6626
(716) 488-1877
(716) 488-1986
Mailing address
15 S MAIN ST, JAMESTOWN, NY 14701-6626
(716) 488-1877
(716) 488-1986
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
NULL
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
NULL
207RC0000X
Cardiovascular Disease Physician
—
—
207RG0100X
Gastroenterology Physician
—
NULL
207RG0100X
Gastroenterology Physician
—
—
207RN0300X
Nephrology Physician
—
NULL
207RN0300X
Nephrology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
NULL
207RP1001X
Pulmonary Disease Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
NULL
207X00000X
Orthopaedic Surgery Physician
—
—
207Y00000X
Otolaryngology Physician
—
NULL
207Y00000X
Otolaryngology Physician
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
Other
Enumeration date
05/07/2014
Last updated
02/03/2020
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