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Organization

MEADVILLE MEDICAL CENTER

Active
Other names
MEADVILLE GASTROENTEROLOGY
Organization subpart
No

Provider details

NPI number
Authorized official
CORY FRANK JACKSON (CONTROLLER)
(814) 333-5766
Entity
Organization

Contact information

Practice address
1034 GROVE ST STE G1, MEADVILLE, PA 16335-2945
(814) 807-1202
(814) 807-1210
Mailing address
1034 GROVE ST, MEADVILLE, PA 16335-2945
(814) 807-1202
(814) 807-1210

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary

Other

Enumeration date
05/03/2022
Last updated
05/03/2022
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