Organization
EVANGELICAL RAD ASSOC LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES O'BRIEN MD (PRES)
(570) 523-7880
Entity
Organization
Contact information
Practice address
1 HOSPITAL DR, LEWISBURG, PA 17837-9314
(570) 523-7880
Mailing address
1 HOSPITAL DR, LEWISBURG, PA 17837-9314
(570) 523-7880
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010447800012
—
PA
Enumeration date
05/10/2006
Last updated
06/02/2008
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