Basic Information
| Provider Information | |||||||||
| NPI: | 1447279807 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GINSBURG | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | LAWRENCE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 130 HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | LEWISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178379315 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5705224110 | ||||||||
| FaxNumber: | 5705224120 | ||||||||
| Practice Location | |||||||||
| Address1: | 55 N 5TH ST | ||||||||
| Address2: | |||||||||
| City: | LEWISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178371407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5705233350 | ||||||||
| FaxNumber: | 5705220404 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD013692E | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | C900 | 01 | PA | HEALTH AMERICA | OTHER | 139480 | 01 | PA | BLUE SHIELD | OTHER | 80080655 | 01 | PA | RAILROAD MEDICARE | OTHER | 19822C3AH | 01 | PA | GEISINGER | OTHER | 0323100 | 01 | PA | KEYSTONE | OTHER |