Organization
CLEARFIELD JEFFERSON HEAD AND NECK SURGICAL ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY JAMES ROSCOE DMD, MD (PRESIDENT)
(814) 375-0455
Entity
Organization
Contact information
Practice address
871 BEAVER DR, DU BOIS, PA 15801-2511
(814) 375-0455
(814) 375-2721
Mailing address
871 BEAVER DR, PO BOX 308, DU BOIS, PA 15801-2511
(814) 375-0455
(814) 375-2721
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD038440L
PA
231H00000X
Audiologist
AT006006
PA
237700000X
Hearing Instrument Specialist
AT006006
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007698100009
—
PA
01
—
2031692
HIGHMARK BLUE SHIELD
PA
01
—
2036569
HIGHMARK BLUE SHIELD
PA
01
—
2038288
HIGHMARK BLUE SHIELD
PA
01
—
219994
HEALTHAMERICA/HEALTHASSURANCE
PA
01
—
3489
GEISINGER HEALTH PLAN
PA
01
—
CL4582
RAILROAD MEDICARE PIN
PA
Enumeration date
11/21/2006
Last updated
09/10/2008
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