# GEISINGER CLINIC

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

## Provider details

- **NPI number:** 1760402192
- **Authorized official:** KENNETH HOLDREN (CAO)
- **Authorized official phone:** (570) 271-5490

## Contact information

- **Practice address:** 200 SCENERY DRIVE, STATE COLLEGE, PA 16801
- **Practice address phone:** (814) 231-4560
- **Mailing address:** 100 N ACADEMY AVE, DANVILLE, PA 17822-3034

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 07/20/2006
- **Last updated:** 06/30/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 644872 | HIGHMARK BS \# | — |