Organization
THOMAS J ALLARDYCE MD PC
Active
Organization
THOMAS J ALLARDYCE MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS J ALLARDYCE MD (PRESIDENT)
(570) 824-2225
Entity
Organization
Contact information
Practice address
150 MUNDY ST, MAC1, WILKES BARRE, PA 18702-6830
(570) 824-2225
(570) 824-6240
Mailing address
150 MUNDY ST, MAC1, WILKES BARRE, PA 18702-6830
(570) 824-2225
(570) 824-6240
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
048075L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015707220004
—
PA
01
—
729472
HIGHMARK BLUE SHIELD
PA
Enumeration date
08/28/2007
Last updated
08/19/2008
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