Organization
DUBOIS REGIONAL MEDICAL CENTER
Active
Parent organization
PENN HIGHLANDS HEALTHCARE
Other names
Penn Highlands DuBois Family Med/Internal Med
Organization subpart
Yes
Provider details
NPI number
Legal business name
PENN HIGHLANDS HEALTHCARE
Authorized official
BRIAN S KLINE (AUTHORIZED OFFICIAL / VP / CFO)
(814) 375-6377
Entity
Organization
Contact information
Practice address
531 HANNAH ST, CLEARFIELD, PA 16830-1209
(814) 765-2261
(814) 765-4421
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 375-6560
(814) 372-2848
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0166056
HIGHMARK ASSIGNMENT ACCOUNT
PA
05
—
1007740880070
—
PA
Enumeration date
07/06/2006
Last updated
11/11/2016
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