Organization
EKG ASSOCIATES OF WYOMING VALLEY LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ELLIS MD (PRESIDENT)
(570) 823-1111
Entity
Organization
Contact information
Practice address
575 N RIVER ST, WILKES BARRE, PA 18764-0999
(570) 288-5441
(570) 288-5842
Mailing address
610 WYOMING AVE, KINGSTON, PA 18704-3702
(570) 288-5441
(570) 288-5842
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0814654
—
PA
Enumeration date
01/29/2007
Last updated
02/18/2009
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