Provider Demographics
NPI:1235225111
Name:CUMMINGS III, GEORGE WILLIAM (DO)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:WILLIAM
Last Name:CUMMINGS III
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 1:102 HILLCREST DRIVE
Mailing Address - Street 2:P.O. BOX 253
Mailing Address - City:ROARING SPRING
Mailing Address - State:PA
Mailing Address - Zip Code:16673-1210
Mailing Address - Country:US
Mailing Address - Phone:814-224-2215
Mailing Address - Fax:814-224-2011
Practice Address - Street 1:102 HILLCREST DRIVE
Practice Address - Street 2:
Practice Address - City:ROARING SPRING
Practice Address - State:PA
Practice Address - Zip Code:16673-1210
Practice Address - Country:US
Practice Address - Phone:814-224-2215
Practice Address - Fax:814-224-2011
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013019208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1010208980001Medicaid
PA1010208980001Medicaid
PA082366D59Medicare ID - Type Unspecified