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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

NPI Number 1225650930
LBN Legal business name THE MODERN COUNTRY DOCTOR, LLC
Authorized official DENNIS FAITH - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/15/2020
Last updated 05/15/2020 - About 6 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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