Organization
DUBOIS REGIONAL MEDICAL CENTER
Active
Parent organization
PENN HIGHLANDS HEALTHCARE
Other names
Penn Highlands DuBois, Penn Highlands Family Medicine Clearfield
Organization subpart
Yes
Provider details
NPI number
Legal business name
PENN HIGHLANDS HEALTHCARE
Authorized official
BRIAN S KLINE (CFO, AUTHORIZED OFFICIAL)
(814) 375-6377
Entity
Organization
Contact information
Practice address
807 TURNPIKE AVE STE 120, CLEARFIELD, PA 16830-1238
(814) 765-2261
(814) 765-4421
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 375-4200
(814) 375-4232
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100774088-0070
—
PA
05
—
100774088-0220
—
PA
01
—
106218
PTAN
PA
Enumeration date
01/03/2022
Last updated
01/03/2022
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