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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 Specialty Code Provider Type

Rural Health

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

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

NPI Number 1376865816
LBN Legal business name PHILLIP STATES, MD, FAMILY PRACTICE
Authorized official PHILLIP STATES - (OWNER/PROPRIETOR)
Entity Organization
Organization subpart 1 No
Enumeration date 02/25/2010
Last updated 12/20/2011 - About 14 years ago
Identifiers
PA License # 393918
PA Medicaid 1019257860003
PA Other 393918 CMS CERTIFICATION NUMBER
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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