Organization
FORNANCE PHYSICIAN SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY JONES (PROVIDER ENROLLMENT MANAGER)
(215) 456-8129
Entity
Organization
Contact information
Practice address
633 W GERMANTOWN PIKE STE 105, PLYMOUTH MEETING, PA 19462-1032
(610) 941-6881
(610) 941-6635
Mailing address
PO BOX 789967, PHILADELPHIA, PA 19178-9967
(484) 622-7395
(414) 622-7399
Taxonomy
Speciality
Code
Description
License number
State
2084A2900X
Neurocritical Care Physician
—
—
2084N0400X
Neurology Physician
Primary
—
—
2084V0102X
Vascular Neurology Physician
—
—
Other
Enumeration date
06/07/2023
Last updated
06/13/2023
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