Basic Information
| Provider Information | |||||||||
| NPI: | 1003218900 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GEISINGER MEDICAL ONCOLOGY SELINSGROVE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 N ACADEMY AVE | ||||||||
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| City: | DANVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 17822 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5702716621 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1575 N OLD TRAIL | ||||||||
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| City: | SELINSGROVE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178706060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5703748555 | ||||||||
| FaxNumber: | 5703749933 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/23/2014 | ||||||||
| LastUpdateDate: | 09/23/2014 | ||||||||
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| AuthorizedOfficialLastName: | MULL | ||||||||
| AuthorizedOfficialFirstName: | CINDY | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR REVENUE CYCLE | ||||||||
| AuthorizedOfficialTelephone: | 5702716603 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RX0202X | 071801 | PA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
No ID Information.