Provider Demographics
NPI:1033168471
Name:GUTHRIE MEDICAL GROUP PC
Entity Type:Organization
Organization Name:GUTHRIE MEDICAL GROUP PC
Other - Org Name:GUTHRIE CLINIC, LTD.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCOPELLITI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-888-5858
Mailing Address - Street 1:1 GUTHRIE SQ
Mailing Address - Street 2:
Mailing Address - City:SAYRE
Mailing Address - State:PA
Mailing Address - Zip Code:18840-1625
Mailing Address - Country:US
Mailing Address - Phone:570-888-5858
Mailing Address - Fax:
Practice Address - Street 1:ROUTE 6 WEST
Practice Address - Street 2:FARM & HOME PLAZA
Practice Address - City:WYALUSING
Practice Address - State:PA
Practice Address - Zip Code:18853
Practice Address - Country:US
Practice Address - Phone:570-746-3500
Practice Address - Fax:570-746-3545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No291U00000XLaboratoriesClinical Medical LaboratoryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAGU616186OtherHIGHMARK BLUE SHIELD
PAGU616186OtherHIGHMARK BLUE SHIELD