Organization
EASTERN PENNSYLVANIA PHYSICIAN ALLIANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD EVANS (VP)
(610) 382-4943
Entity
Organization
Contact information
Practice address
2 HOSPITAL DR, CLARION, PA 16214-8502
(814) 226-9545
(814) 226-9097
Mailing address
367 S GULPH RD, KING OF PRUSSIA, PA 19406-3121
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
PA
Enumeration date
11/06/2019
Last updated
12/16/2024
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