Provider Demographics
NPI:1164523809
Name:CARLISLE DIGESTIVE DISEASE ASSOCIATES, LTD.
Entity Type:Organization
Organization Name:CARLISLE DIGESTIVE DISEASE ASSOCIATES, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-245-2228
Mailing Address - Street 1:241 ALEXANDER SPRING RD
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17015-6953
Mailing Address - Country:US
Mailing Address - Phone:717-245-2228
Mailing Address - Fax:717-245-0806
Practice Address - Street 1:241 ALEXANDER SPRING RD
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17015-6953
Practice Address - Country:US
Practice Address - Phone:717-245-2228
Practice Address - Fax:717-245-0806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACF6302OtherRR MEDICARE
PACF6302OtherRR MEDICARE