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Organization

WELLSPAN MEDICAL GROUP

Active
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Organization

WELLSPAN MEDICAL GROUP

Active
Other names
WELLSPAN FAMILY MEDICINE - FAIRFIELD
Organization subpart
No

Provider details

NPI number
Authorized official
LAURA FRANK (CVO-MANAGER)
(717) 851-1405
Entity
Organization

Contact information

Practice address
4910 FAIRFIELD RD STE A, FAIRFIELD, PA 17320-9510
(717) 339-3175
(717) 255-0950
Mailing address
601 MEMORY LN, YORK, PA 17402-2231
(717) 851-1405
(717) 851-6969

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03181900
CAPITAL BLUE CROSS
PA
05
—
1007721360126
—
PA
01
—
130408
UNISON
PA
01
—
1382350
HIGHMARK BLUE SHIELD
PA
01
—
1527201
GATEWAY
PA
01
—
20013074
AMERIHEALTH MERCY
PA
01
—
2073722002
AMERIHEALTH 65 PA
PA
01
—
401065503
MARYLAND MEDICAID
MD
01
—
462M
MARYLAND MEDICARE
MD
01
—
7579833
AETNA
PA
01
—
800174
JOHN HOPKINS
PA
01
—
CA3246
RAILROAD
PA
01
—
S1ET
GEISINGER
PA
Enumeration date
12/01/2006
Last updated
01/24/2025
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