Organization
LOCK HAVEN CLINIC COMPANY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOPHIA L ARWOOD (DIRECTOR)
(615) 628-6038
Entity
Organization
Contact information
Practice address
24 CREE DR, LOCK HAVEN, PA 17745-2639
(570) 893-5330
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(866) 647-5068
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RN0300X
Nephrology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
208800000X
Urology Physician
—
—
208M00000X
Hospitalist Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013815860001
—
PA
05
—
101821389 0001
—
PA
Enumeration date
10/12/2006
Last updated
01/16/2014
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