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Organization

GOOD SAMARITAN PHYSICIAN SERVICES

Active
Other names
WellSpan Cardiothoracic Surgery - Lebanon
Organization subpart
No

Provider details

NPI number
Authorized official
JODY M BOGER (CREDENTIALING COORDINATOR)
(717) 270-7780
Entity
Organization

Contact information

Practice address
4TH & WALNUT STREETS, 2ND FLOOR, LEBANON, PA 17042-6123
(717) 270-3751
(717) 270-3754
Mailing address
PO BOX 300, LEBANON, PA 17042-0300
(717) 270-7780
(717) 274-9746

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001864024
PA
Enumeration date
02/24/2009
Last updated
10/05/2016
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