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Organization

INDIANA HEALTHCARE PHYSICIAN SERVICES, INC

Active
Parent organization
INDIANA HEALTHCARE PHYSICIAN SERVICES, INC
Other names
D/B/A Punxsutawney Physician Group
Organization subpart
Yes

Provider details

NPI number
Legal business name
INDIANA HEALTHCARE PHYSICIAN SERVICES, INC
Authorized official
BRETT BRAUN (CHIEF OPERATING OFFICER)
(888) 452-4762
Entity
Organization

Contact information

Practice address
81 HILLCREST DR, PUNXSUTAWNEY, PA 15767-2605
(814) 938-1451
(814) 938-1451
Mailing address
81 HILLCREST DR, PUNXSUTAWNEY, PA 15767-2605
(814) 938-1451
(814) 938-1451

Taxonomy

Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
MD450924
PA
207Y00000X
Otolaryngology Physician
MD450155
PA
208600000X
Surgery Physician
MD446903
PA
208600000X
Surgery Physician
MD447392
PA
208800000X
Urology Physician
208D00000X
General Practice Physician
MD037172L
PA
208D00000X
General Practice Physician
Primary
MD417193
PA
363LF0000X
Family Nurse Practitioner
SP012816
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0015479580004
PA
01
BO65
UPMC
PA
Enumeration date
09/20/2006
Last updated
03/20/2019
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