# SUSQUEHANNA PHYSICIAN SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Susquehanna Health Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770719882
- **Authorized official:** MELISSA DAVIS (COO)
- **Authorized official phone:** (570) 326-8544

## Contact information

- **Practice address:** 740 HIGH STREET, SUITE 1004, WILLIAMSPORT, PA 17701-3100
- **Practice address phone:** (570) 321-3300
- **Practice address fax:** (570) 321-3301
- **Mailing address:** 1201 GRAMPIAN BLVD, WILLIAMSPORT, PA 17701-1900

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 207VM0101X | Maternal & Fetal Medicine Physician | — | NULL | — |
| 207VM0101X | Maternal & Fetal Medicine Physician | — | — | — |
| 363LW0102X | Women's Health Nurse Practitioner | — | NULL | — |
| 363LW0102X | Women's Health Nurse Practitioner | — | — | — |
| 367A00000X | Advanced Practice Midwife | — | NULL | — |
| 367A00000X | Advanced Practice Midwife | — | — | — |

## Other

- **Enumeration date:** 06/03/2009
- **Last updated:** 07/16/2026