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Individual

JOHN KEITH MCILWAINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-0002
(570) 271-6389
(570) 271-6021
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
227083
MA
207R00000X
Internal Medicine Physician
OS013009
PA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
227083
MA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
OS013009
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1011340930001
PA
05
2114534
MA
Enumeration date
07/14/2005
Last updated
08/11/2020
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