Organization
WAYNE MEMORIAL COMMUNITY HEALTH CENTERS
Active
Other names
Honesdale Surgical
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERICK JACKSON (EXECUTIVE DIRECTOR)
(570) 253-8450
Entity
Organization
Contact information
Practice address
600 MAPLE AVE, SUITE 1, HONESDALE, PA 18431-1459
(570) 253-8635
Mailing address
601 PARK ST, HONESDALE, PA 18431-1445
(570) 253-8635
(570) 253-8646
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
05/16/2016
Last updated
05/16/2016
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