Organization
TIADAGHTON EMERGENCY PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES L. MURPHY (EXECUTIVE VICE PRESIDENT)
(800) 444-7009
Entity
Organization
Contact information
Practice address
24 CREE DR, EMERGENCY DEPARTMENT, LOCK HAVEN, PA 17745-2639
(570) 893-5040
Mailing address
PO BOX 41727, PHILADELPHIA, PA 19101-1727
(800) 444-7009
(800) 305-3233
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019699570001
—
PA
01
—
TI1567176
BLUE SHIELD
PA
Enumeration date
07/04/2006
Last updated
04/20/2008
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