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Contact Information

THE MODERN COUNTRY DOCTOR, LLC
23 INDUSTRIAL BLVD STE D
PAOLI, PA19301-1601
 Phone: 610-890-8522
 Fax: 484-568-4748
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Clinic/Center

261Q00000X
 

Rural Health

261QR1300X B4[14] Rural Health Clinic
Indicates primary specialty

NPI Profile & details for THE MODERN COUNTRY DOCTOR LLC · (Female)

NPI # 1225650930
Status Active
Credentials
Entity Individual
Enumeration date 05/15/2020
Last updated 05/15/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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