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Organization

FORNANCE PHYSICIAN SERVICES, INC.

Active
Other names
Montgomery Family Practice
Organization subpart
No

Provider details

NPI number
Authorized official
VERA BURNETT-ROBINS (DIRECTOR PHYSICIAN BILLING)
(484) 622-7391
Entity
Organization

Contact information

Practice address
1330 POWELL ST, SUITE 409, NORRISTOWN, PA 19401-3353
(610) 277-0964
(610) 270-2184
Mailing address
PO BOX 789967, PHILADELPHIA, PA 19178-9967
(484) 622-7395
(484) 622-7399

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207QG0300X
Geriatric Medicine (Family Medicine) Physician
208D00000X
General Practice Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0018110
AETNA HMO
PA
01
0047315001
IBC - PC/KHPE
PA
01
1016391
KEYSTONE MERCY
PA
05
1738323
PA
01
17713
HEALTH PARTNERS SITE #
PA
01
2326372
CIGNA HMO/PPO
PA
01
4439614
AETNA PPO
PA
01
444971
HIGHMARK BLUE SHIELD
PA
01
CC4910
RRM
PA
Enumeration date
06/08/2006
Last updated
11/14/2018
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