National Provider Identifier Database

PHILLIP STATES MD FAMILY PRACTICE
Rural Health


Contact Information

PHILLIP STATES, MD, FAMILY PRACTICE
81 HILLCREST DR
SUITE 1300
PUNXSUTAWNEY, PA15767-2605
Phone: 814-938-3550
Fax: 814-938-3679
Website:
Specialty Taxonomy Code
* Rural Health 261QR1300X

* Indicates primary specialty

NPI Profile & details for PHILLIP STATES, MD, FAMILY PRACTICE

NPI Number 1376865816
Legal business name
LBN
PHILLIP STATES, MD, FAMILY PRACTICE
Authorized official PHILLIP STATES - (OWNER/PROPRIETOR)
Entity Organization
Organization subpart No
Enumeration date 02/25/2010
Last updated 12/20/2011 - About 14 years ago
Sole proprietor1 Not specified
Identifiers
  • PA License #: 393918
  • PA Medicaid: 1019257860003
  • PA Other: 393918 CMS CERTIFICATION NUMBER

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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