Individual
JOSE R ACOSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
27 SANDY LANE, SUITE 140, LEWISTOWN, PA 17044-1318
(717) 242-2711
(717) 248-0502
Mailing address
400 HIGHLAND AVENUE, LEWISTOWN, PA 17044-1167
(717) 242-7707
(717) 242-7083
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD038970L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000805646
—
PA
05
—
0008056460001
—
PA
01
—
02552500
CAPITAL BLUE CROSS
PA
01
—
060000161
RAILROAD MEDICARE
PA
01
—
076706
BLUE SHIELD
PA
Enumeration date
05/04/2006
Last updated
09/08/2011
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