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Organization
LANCASTER GENERAL MEDICAL GROUP
Active
Organization
LANCASTER GENERAL MEDICAL GROUP
Active
Other names
Penn Medicine LGHP Family Medicine Crooked Oak
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE KENNEDY (VICE PRESIDENT FINANCIAL SERVICES)
(717) 544-5010
Entity
Organization
Contact information
Practice address
1655 CROOKED OAK DR, LANCASTER, PA 17601-4207
(717) 569-2678
(717) 569-1730
Mailing address
1655 CROOKED OAK DR, LANCASTER, PA 17601-4207
(717) 569-2678
(717) 569-1730
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03003700
CAPITAL BLUE CROSS
PA
01
—
074083
HIGHMARK BLUE SHIELD
PA
05
—
1007327490094
—
PA
01
—
1518616
GATEWAY HEALTH PLAN
PA
01
—
3727597
AETNA HMO
PA
01
—
5706523
AETNA NON-HMO
PA
01
—
873450
AETNA CAP OFFICE#
PA
01
—
CE7357
RAILROAD MEDICARE
PA
01
—
S1QB
GEISINGER HEALTH PLAN
PA
Enumeration date
09/19/2005
Last updated
11/17/2020
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