Organization
EVANGELICAL MEDICAL SERVICES ORGANIZATION
Active
Other names
WellSpan Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
KENDRA A AUCKER (SENIOR VICE PRESIDENT/PRESIDENT)
(570) 522-2807
Entity
Organization
Contact information
Practice address
1 HOSPITAL DR, LEWISBURG, PA 17837-9350
(570) 522-4110
(570) 768-3911
Mailing address
1 HOSPITAL DR STE 306, LEWISBURG, PA 17837-9350
(570) 522-4110
(570) 768-3911
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001881626
HIGHMARK BLUE SHIELD
PA
05
—
1007498260092
—
PA
01
—
118438703
DEPARTMENT OF LABOR
PA
01
—
50062067
CAPITAL BLUE CROSS
PA
01
—
CA5965
RAILROAD MEDICARE
PA
Enumeration date
09/21/2006
Last updated
03/04/2026
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