Organization
DUBOIS REGIONAL MEDICAL GROUP, PC
Active
Parent organization
PENN HIGHLANDS HEALTHCARE
Organization subpart
Yes
Provider details
NPI number
Legal business name
PENN HIGHLANDS HEALTHCARE
Authorized official
MR. JOHN S SUTIKA (AUTHORIZED OFFICIAL & SECRETARY)
(814) 375-3385
Entity
Organization
Contact information
Practice address
145 HOSPITAL AVE STE 104, DU BOIS, PA 15801-1463
(814) 375-8055
(814) 375-8056
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 375-4200
(814) 375-4232
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
PA
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
207RB0002X
Obesity Medicine (Internal Medicine) Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
PA
207Y00000X
Otolaryngology Physician
—
—
2080P0202X
Pediatric Cardiology Physician
—
—
208600000X
Surgery Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
—
PA
213E00000X
Podiatrist
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
063246
PTAN
PA
05
—
100751931
—
PA
Enumeration date
03/11/2009
Last updated
10/14/2021
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