Provider Demographics
NPI:1104864214
Name:KIRCHNER, JEFFREY (DO)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:KIRCHNER
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 1:555 N DUKE ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2250
Mailing Address - Country:US
Mailing Address - Phone:717-544-5511
Mailing Address - Fax:
Practice Address - Street 1:554 N DUKE ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2225
Practice Address - Country:US
Practice Address - Phone:717-544-1960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS005934L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50082783OtherCAPITAL BLUE CROSS
PA20074910OtherAMERIHEALTH MERCY
PA4257191OtherAETNA
PA000000127153OtherUNISON
PA0444252000OtherINDEPENDENCE BLUE CROSS
PAP002788OtherGATEWAY
PA000615948OtherHIGHMARK BLUE SHIELD
PA0012205460004Medicaid
PA080100818OtherRAILROAD MEDICARE
PA0444252000OtherINDEPENDENCE BLUE CROSS