Provider Demographics
NPI:1033134192
Name:ESPER, ALAN N (DO)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:N
Last Name:ESPER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5473 VILLAGE COMMON DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-4961
Mailing Address - Country:US
Mailing Address - Phone:814-835-9191
Mailing Address - Fax:
Practice Address - Street 1:5473 VILLAGE COMMON DR
Practice Address - Street 2:SUITE 201
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-4961
Practice Address - Country:US
Practice Address - Phone:814-835-9191
Practice Address - Fax:814-835-3323
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS004681L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB40041Medicare UPIN
PAES153385Medicare ID - Type Unspecified