Provider Demographics
NPI:1053478362
Name:VUKMER, GEORGE J JR (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:J
Last Name:VUKMER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1058 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-4332
Mailing Address - Country:US
Mailing Address - Phone:814-336-1555
Mailing Address - Fax:814-724-5035
Practice Address - Street 1:1058 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-4332
Practice Address - Country:US
Practice Address - Phone:814-336-1555
Practice Address - Fax:814-724-5035
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-039316-E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0180011180OtherRAILROAD MEDICARE
PA0011140980002Medicaid
PA205054OtherUPMC
PAB42317Medicare UPIN
PA205054OtherUPMC