Organization
DUBOIS REG MED CTR - PH DUBOIS FAM MED/INTERNAL MED ST MARYS
Active
Parent organization
PENN HIGHLANDS HEALTHCARE
Other names
Penn Highlands DuBois
Organization subpart
Yes
Provider details
NPI number
Legal business name
PENN HIGHLANDS HEALTHCARE
Authorized official
BRIAN S KLINE (VP/CFO)
(814) 375-6377
Entity
Organization
Contact information
Practice address
757 JOHNSONBURG RD, SAINT MARYS, PA 15857-3488
(814) 371-2200
(814) 375-4232
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 371-2200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007740880070
—
PA
Enumeration date
07/27/2015
Last updated
02/29/2016
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