Organization
DUBOIS REGIONAL MEDICAL CENTER
Active
Parent organization
PENN HIGHLANDS HEALTHCARE
Other names
Penn Highlands Dubois Family Med-Prusakowski
Organization subpart
Yes
Provider details
NPI number
Legal business name
PENN HIGHLANDS HEALTHCARE
Authorized official
BRIAN S KLINE (AUTHORIZED OFFICIAL, VP, & CFO)
(814) 375-6377
Entity
Organization
Contact information
Practice address
90 HOSPITAL RD, SUITE 200, BROOKVILLE, PA 15825-1382
(814) 849-1874
(814) 849-1444
Mailing address
100 HOSPITAL AVENUE, DUBOIS, PA 15801-1440
(814) 375-4200
(814) 375-4232
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
PA
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007740880169
—
PA
Enumeration date
05/18/2009
Last updated
04/08/2016
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