Geisinger South Wilkes Barre

NPI #1023068533 in Wilkes Barre, Pennsylvania

Provider Information

NPI Number: 1023068533
Entity Type: Organization
Organization Name: Geisinger South Wilkes Barre
Primary Specialty: Internal Medicine
Enumeration Date: May 12, 2006
Last Updated: Jun 30, 2008

Practice Location

Address: 25 CHURCH ST
City: Wilkes Barre
State: Pennsylvania
ZIP Code: 18765
Phone: (570) 826-3293

Authorized Official

Name: KENNETH HOLDREN
Title: CAO
Phone: (570) 271-5490

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery)	208G00000X
Physician Assistant	363A00000X
Nurse Practitioner	363L00000X
Internal Medicine	207R00000X	Primary

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