Organization
LEBANON INTERNAL MEDICINE ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS V KANTOR M.D. (GROUP PRESIDENT)
(717) 273-6706
Entity
Organization
Contact information
Practice address
755 NORMAN DR, LEBANON, PA 17042-7497
(717) 273-6706
(717) 273-1435
Mailing address
755 NORMAN DR, LEBANON, PA 17042-7497
(717) 273-6706
(717) 273-1435
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02377100
CAPITAL BLUE CROSS
PA
05
—
1007532100010
—
PA
01
—
104037
HIGHMARK BLUE SHIELD
PA
01
—
1511102
GATEWAY - PRIMARY CARE
PA
01
—
1520937
GATEWAY - SPECIALIST
PA
Enumeration date
08/19/2005
Last updated
02/03/2010
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