Organization
GEISINGER CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH HOLDREN (CAO)
(570) 271-5490
Entity
Organization
Contact information
Practice address
1000 E MOUNTAIN DR, WILKES BARRE, PA 18711-0027
(570) 826-7300
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-3034
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Enumeration date
05/17/2006
Last updated
06/30/2008
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