Organization
FAMILY PRACTICE ASSOCIATES OF WESTERN PA, PC
Active
Other names
FAMILY PRACTICE ASSOCIATES
Organization subpart
No
Provider details
NPI number
Authorized official
JAYMIE DAVIS (MANAGER)
(330) 758-2775
Entity
Organization
Contact information
Practice address
188 ENCLAVE DR, NEW CASTLE, PA 16105-3208
(330) 758-2775
(330) 758-2787
Mailing address
PO BOX 5100, NEW CASTLE, PA 16105
(330) 758-2775
(330) 758-2787
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
605344
BLUE SHIELD
PA
01
—
CH7004
MEDICARE TRAVELERS
PA
Enumeration date
03/19/2007
Last updated
05/09/2008
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