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Organization

FAMILY PRACTICE CENTER, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BENJAMIN RYAN WILLIARD (CEO)
(570) 743-1703
Entity
Organization

Contact information

Practice address
7 DOCK HILL RD, MIDDLEBURG, PA 17842-8910
(570) 837-2123
(570) 837-2185
Mailing address
7 DOCK HILL RD, MIDDLEBURG, PA 17842-8910
(570) 837-2123
(570) 837-2185

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
103T00000X
Psychologist
1041C0700X
Clinical Social Worker
106H00000X
Marriage & Family Therapist
207Q00000X
Family Medicine Physician
Primary
207QS0010X
Sports Medicine (Family Medicine) Physician
207R00000X
Internal Medicine Physician
207RS0012X
Sleep Medicine (Internal Medicine) Physician
208000000X
Pediatrics Physician
225100000X
Physical Therapist
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner
363LG0600X
Gerontology Nurse Practitioner
363LP0200X
Pediatric Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1007775260016
PA
05
1007775260143
PA
01
154750
MEDICARE
PA
Enumeration date
05/23/2006
Last updated
08/27/2024
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