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Organization

DUBOIS REGIONAL MEDICAL CENTER

Active
Parent organization
PENN HIGHLANDS HEALTHCARE
Other names
Penn Highlands Urology
Organization subpart
Yes

Provider details

NPI number
Legal business name
PENN HIGHLANDS HEALTHCARE
Authorized official
MR. BRIAN S KLINE (VP & CFO)
(814) 375-6377
Entity
Organization

Contact information

Practice address
145 HOSPITAL AVE, SUITE 200, DU BOIS, PA 15801-1462
(814) 375-9200
(814) 375-9980
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 375-9200
(814) 375-9980

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001672897
HIGHMARK BLUE CROSS
PA
Enumeration date
09/12/2006
Last updated
12/18/2014
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