Organization
WAYNE SURGICAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE W TIETJEN MD (OWNER)
(570) 253-2620
Entity
Organization
Contact information
Practice address
507 HIGH ST, HONESDALE, PA 18431-1733
(570) 253-2620
(570) 253-2651
Mailing address
507 HIGH ST, HONESDALE, PA 18431-1733
(570) 253-2620
(570) 253-2651
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD016938E
PA
Other
Enumeration date
10/09/2007
Last updated
06/20/2011
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