Basic Information
Provider Information | |||||||||
NPI: | 1679560858 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | BOBEK | ||||||||
FirstName: | FRANCIS | ||||||||
MiddleName: | B | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 100 N ACADEMY AVE | ||||||||
Address2: |   | ||||||||
City: | DANVILLE | ||||||||
State: | PA | ||||||||
PostalCode: | 178224903 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5702716144 | ||||||||
FaxNumber: | 5702716578 | ||||||||
Practice Location | |||||||||
Address1: | 106 SOUTH MARKET STREET | ||||||||
Address2: |   | ||||||||
City: | ELYSBURG | ||||||||
State: | PA | ||||||||
PostalCode: | 178249445 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5706722574 | ||||||||
FaxNumber: | 5706720151 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 10/03/2005 | ||||||||
LastUpdateDate: | 08/06/2020 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 08/06/2020 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD027560E | PA | Y |   | Allopathic & Osteopathic Physicians | Family Medicine |   |
ID Information
ID | Type | State | Issuer | Description | 13468 | 01 |   | GEISINGER HEALTH PLAN | OTHER | 017015700 | 01 |   | FEDERAL BLACK LUNG | OTHER | 0009761510002 | 05 | PA |   | MEDICAID | 080006226 | 01 |   | MEDICARE-THE TRAVELERS IN | OTHER | 0051527000 | 01 | PA | PERSONAL CHOICE | OTHER | 02588800 | 01 | PA | CAPITAL BLUE CROSS | OTHER | B00000138049 | 01 | PA | PA BLUE SHIELD | OTHER | 28171 | 01 |   | HEALTH AMERICA | OTHER | P006088 | 01 |   | GATEWAY HEALTH PLAN | OTHER | 000000091225 | 01 |   | THREE RIVERS HEALTH PLAN | OTHER | 5923619 | 01 |   | AETNA | OTHER | 000991313 | 01 | PA | KEYSTONE HEALTH PLAN CENT | OTHER |