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Organization

FOGGY BOTTOM PHYSICIAN GROUP INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TODD EVANS (VP)
(610) 382-4422
Entity
Organization

Contact information

Practice address
1200 PECAN ST SE, WASHINGTON, DC 20032-2652
(771) 444-6146
Mailing address
367 S GULPH RD, KING OF PRUSSIA, PA 19406-3121
(610) 382-4422

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary

Other

Enumeration date
07/09/2025
Last updated
03/30/2026
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