Organization
DUBOIS REGIONAL MEDICAL GROUP, PC
Active
Parent organization
PENN HIGHLANDS HEALTHCARE
Other names
DRMG Clearfield Center for Children's Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
PENN HIGHLANDS HEALTHCARE
Authorized official
MR. JOHN S SUTIKA (AUTHORIZED OFFICIAL & SECRETARY)
(814) 375-3385
Entity
Organization
Contact information
Practice address
1033 TURNPIKE AVE, SUITE 200, CLEARFIELD, PA 16830-3061
(814) 768-7618
Mailing address
100 HOSPITAL AVE, BILLING DEPARTMENT, DU BOIS, PA 15801-1440
(814) 375-6566
(814) 375-2848
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002158632
HIGHMARK ASSIGNMENT ACCOUNT
PA
05
—
100751931
—
PA
Enumeration date
05/29/2008
Last updated
04/27/2016
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