Provider Demographics
NPI:1023205929
Name:MAGLEY FAMILY PRACTICE, INC
Entity Type:Organization
Organization Name:MAGLEY FAMILY PRACTICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:MAGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-472-7320
Mailing Address - Street 1:1100 W HIGH ST
Mailing Address - Street 2:
Mailing Address - City:EBENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15931-1706
Mailing Address - Country:US
Mailing Address - Phone:814-472-7320
Mailing Address - Fax:814-472-5666
Practice Address - Street 1:1100 W HIGH ST
Practice Address - Street 2:
Practice Address - City:EBENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15931-1706
Practice Address - Country:US
Practice Address - Phone:814-472-7320
Practice Address - Fax:814-472-5666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPENDINGMedicare PIN