Organization
TIOGA HEALTHCARE PROVIDERS INC-6
Active
Parent organization
LAUREL HEALTH SYSTEMS
Other names
Canyon Surgical Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAUREL HEALTH SYSTEMS
Authorized official
BRADLEY MUDGE DO (PHYSICIAN)
(570) 723-0716
Entity
Organization
Contact information
Practice address
1 MAIN ST, WELLSBORO, PA 16901-1601
(570) 723-0716
(570) 723-0638
Mailing address
PO BOX 191, WELLSBORO, PA 16901-0191
(570) 723-0716
(570) 723-0638
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1626712
HIGHMARK BLUE SHIELD
—
01
—
DC0711
TRAVELERS MEDICARE
PA
Enumeration date
01/31/2006
Last updated
01/08/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us