Organization
COMMONWEALTH PHYSICIAN NETWORK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINA MUSIC (DIRECTOR PROVIDER ENROLLMENT)
(877) 892-9815
Entity
Organization
Contact information
Practice address
610 WYOMING AVE, KINGSTON, PA 18704-3702
(570) 288-5441
(570) 288-9613
Mailing address
4000 MERIDIAN BLVD, FRANKLIN, TN 37067-6325
(615) 465-7000
(615) 628-6877
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
208600000X
Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102897748 0001
—
PA
Enumeration date
01/16/2014
Last updated
07/09/2025
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