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Organization
MEADVILLE MEDICAL CENTER
Active
Organization
MEADVILLE MEDICAL CENTER
Active
Other names
Meadville Endocrinology
Organization subpart
No
Provider details
NPI number
Authorized official
CORY FRANK JACKSON (CONTROLLER)
(814) 333-5766
Entity
Organization
Contact information
Practice address
765 LIBERTY ST STE 307A, MEADVILLE, PA 16335-2566
(814) 373-4270
(814) 373-4273
Mailing address
1034 GROVE ST, MEADVILLE, PA 16335-2945
(814) 373-4270
(814) 373-4273
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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