# GEISINGER-HM JOINT VENTURE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GMG Lycoming Family Practice
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740836808
- **Authorized official:** CINDY L MULL (SYSTEM DIRECTOR)
- **Authorized official phone:** (570) 271-6603

## Contact information

- **Practice address:** 780 BROAD ST, MONTOURSVILLE, PA 17754-2419
- **Practice address phone:** (570) 368-2870
- **Practice address fax:** (570) 368-4463
- **Mailing address:** 100 N ACADEMY AVE, DANVILLE, PA 17822-4903
- **Mailing address phone:** (570) 271-6144
- **Mailing address fax:** (570) 271-6578

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 207ZP0105X | Clinical Pathology/Laboratory Medicine Physician | — | NULL | — |
| 207ZP0105X | Clinical Pathology/Laboratory Medicine Physician | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 08/14/2019
- **Last updated:** 01/08/2021