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Organization
STISH FAMILY PRACTICE PC
Active
Organization
STISH FAMILY PRACTICE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EUGENE STISH MD (PRESIDENT)
(570) 788-1108
Entity
Organization
Contact information
Practice address
600 PENN ST, WEST HAZLETON, PA 18202-1514
(570) 497-4940
(570) 497-4942
Mailing address
PO BOX 1388, KINGSTON, PA 18704-0388
(570) 288-8881
(570) 288-8065
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002708
FIRST PRIORITY HEALTH
—
01
—
514293
PA BLUE SHIELD
PA
Enumeration date
06/27/2006
Last updated
03/28/2017
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