Provider Demographics
NPI:1326112566
Name:SURGICAL ASSOCIATES OF HUNTINGDON, P.C.
Entity Type:Organization
Organization Name:SURGICAL ASSOCIATES OF HUNTINGDON, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:SCHALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-643-4876
Mailing Address - Street 1:1227 WARM SPRINGS AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:16652-2300
Mailing Address - Country:US
Mailing Address - Phone:814-643-4876
Mailing Address - Fax:814-643-6595
Practice Address - Street 1:1227 WARM SPRINGS AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-2300
Practice Address - Country:US
Practice Address - Phone:814-643-4876
Practice Address - Fax:814-643-6595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA678446OtherBLUE SHIELD
PA0012492400006Medicaid
PA0012492400006Medicaid