Organization
FAIR HILL COMMUNITY PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERA GREEN (CREDENTIALING MANAGER)
(267) 264-4669
Entity
Organization
Contact information
Practice address
133 W HUNTING PARK AVE, PHILADELPHIA, PA 19140-2717
(215) 324-0600
(215) 324-2795
Mailing address
100 E LEHIGH AVE, PHILADELPHIA, PA 19125-1012
(267) 264-4669
(215) 707-0071
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
04/27/2023
Last updated
05/13/2026
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