Basic Information
| Provider Information | |||||||||
| NPI: | 1417918749 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SUN ORTHOPAEDIC GROUP, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 900 BUFFALO RD | ||||||||
| Address2: | |||||||||
| City: | LEWISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178372800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5705244446 | ||||||||
| FaxNumber: | 5705221110 | ||||||||
| Practice Location | |||||||||
| Address1: | 900 BUFFALO RD | ||||||||
| Address2: | |||||||||
| City: | LEWISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178372800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5705244446 | ||||||||
| FaxNumber: | 5705221110 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | THOMS | ||||||||
| AuthorizedOfficialFirstName: | LINDA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OPERATIONS MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 5705244446 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.