| NPI | 1902881477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA L HATT Manager Provider Enrollment 814-572-3236 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 103T00000X Psychologist |
| 1041C0700X Social Worker Clinical | |
| 207Q00000X Family Medicine | |
| 207QS0010X Family Medicine Sports Medicine | |
| 207RG0100X Internal Medicine Gastroenterology | |
| 207RI0200X Internal Medicine Infectious Disease | |
| 207T00000X Neurological Surgery | |
| 208000000X Pediatrics | |
| 2080N0001X Pediatrics Neonatal-Perinatal Medicine | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 208600000X Surgery | |
| 2086X0206X Surgery Surgical Oncology | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) | |
| 261QR1300X Clinic/Center Rural Health | |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2025-06-25 |