Organization
DUBOIS REGIONAL MEDICAL CENTER
Active
Parent organization
PENN HIGHLANDS HEALTHCARE
Other names
Penn Highlands DuBois, Penn Highlands Family Medicine & Pediatric Care
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
21911 ROUTE 119, PUNXSUTAWNEY, PA 15767
(814) 938-2602
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 375-4200
(814) 375-4232
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100774088
—
PA
01
—
106218
PTAN
PA
Enumeration date
10/19/2021
Last updated
03/25/2022
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