Organization
DUBOIS REGIONAL MEDICAL CENTER
Active
Parent organization
PENN HIGHLANDS HEALTHCARE
Other names
Penn Highlands Family Medicine - Ignatius
Organization subpart
Yes
Provider details
NPI number
Legal business name
PENN HIGHLANDS HEALTHCARE
Authorized official
MR. BRIAN S KLINE (VP & CFO)
(814) 375-6377
Entity
Organization
Contact information
Practice address
145 HOSPITAL AVE STE 106, DU BOIS, PA 15801-1463
(814) 371-0373
(814) 371-0359
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 371-0373
(814) 371-0359
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
PA
207R00000X
Internal Medicine Physician
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100774088-0070
—
PA
Enumeration date
03/15/2010
Last updated
11/03/2017
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