Organization
DUBOIS REGIONAL MEDICAL CENTER
Active
Parent organization
PENN HIGHLANDS HEALTHCARE
Other names
Penn Highlands DuBois, Penn Highlands DuBois - Sunflower Dr Bldg
Organization subpart
Yes
Provider details
NPI number
Legal business name
PENN HIGHLANDS HEALTHCARE
Authorized official
BRIAN S KLINE (VP/CFO/AUTHORIZED OFFICIAL)
(814) 375-6377
Entity
Organization
Contact information
Practice address
529 SUNFLOWER DR, DU BOIS, PA 15801-2378
(814) 371-2200
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 375-6560
(814) 372-2848
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
—
—
207WX0107X
Retina Specialist (Ophthalmology) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007740880070
—
PA
Enumeration date
06/05/2019
Last updated
06/05/2019
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