Provider Demographics
NPI:1245428549
Name:JOHN A. SCANLAND DPMPC
Entity Type:Organization
Organization Name:JOHN A. SCANLAND DPMPC
Other - Org Name:SCANLAND FOOT & ANKLE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCANLAND
Authorized Official - Suffix:
Authorized Official - Credentials:DPMPC
Authorized Official - Phone:570-489-4432
Mailing Address - Street 1:1834 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BLAKELY
Mailing Address - State:PA
Mailing Address - Zip Code:18447-1370
Mailing Address - Country:US
Mailing Address - Phone:570-489-4432
Mailing Address - Fax:570-489-8083
Practice Address - Street 1:1834 MAIN ST
Practice Address - Street 2:
Practice Address - City:BLAKELY
Practice Address - State:PA
Practice Address - Zip Code:18447-1370
Practice Address - Country:US
Practice Address - Phone:570-489-4432
Practice Address - Fax:570-489-8083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009388940002Medicaid
PA480021736OtherRAILROAD MEDICARE
PA4035950001Medicare NSC
PA480021736OtherRAILROAD MEDICARE