Organization
DUBOIS REGIONAL MEDICAL CENTER
Active
Organization
DUBOIS REGIONAL MEDICAL CENTER
Active
Parent organization
PENN HIGHLANDS HEALTHCARE
Other names
Penn Highlands Internal Med Elk/Family Med Elk
Organization subpart
Yes
Provider details
NPI number
Legal business name
PENN HIGHLANDS HEALTHCARE
Authorized official
MR. BRIAN S KLINE (CFO)
(814) 375-6377
Entity
Organization
Contact information
Practice address
99 HOSPITAL ST, RIDGWAY, PA 15853-1948
(814) 788-5660
(814) 788-5663
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 788-5660
(814) 788-5663
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
PA
207R00000X
Internal Medicine Physician
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
089128
MEDICARE PTAN
PA
05
—
1007740880070
—
PA
01
—
106218
MEDICARE PTAN
PA
Enumeration date
11/19/2009
Last updated
10/20/2016
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