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Organization

GOOD SAMARITIAN PHYSICIAN SERVICES

Active
Other names
WellSpan General Surgery - Lebanon
Organization subpart
No

Provider details

NPI number
Authorized official
JODY M BOGER (CREDENTIALING COORDINATOR)
(717) 270-7780
Entity
Organization

Contact information

Practice address
735 NORMAN DR, SUITE 3, LEBANON, PA 17042-7559
(717) 270-7908
(717) 272-1734
Mailing address
PO BOX 300, LEBANON, PA 17042-0300
(717) 270-7780

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001864024
PA
Enumeration date
11/19/2008
Last updated
10/05/2016
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