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Organization
SUSQUEHANNA PHYSICIAN SERVICES
Active
Organization
SUSQUEHANNA PHYSICIAN SERVICES
Active
Other names
Susquehanna Health Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
LORETTA V MYERS CPCS, PESC (CREDENTIALING COORDINATOR)
(570) 320-7838
Entity
Organization
Contact information
Practice address
700 HIGH ST, WILLIAMSPORT, PA 17701-3100
(570) 321-2125
(570) 321-2192
Mailing address
1201 GRAMPIAN BLVD, WILLIAMSPORT, PA 17701-1900
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
07/30/2019
Last updated
07/30/2019
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