Provider Demographics
NPI:1326601816
Name:JOHN SCHELAND, DPM PC
Entity Type:Organization
Organization Name:JOHN SCHELAND, DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHELAND
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:570-586-5687
Mailing Address - Street 1:3 ABINGTON EXECUTIVE PARK STE 7
Mailing Address - Street 2:
Mailing Address - City:CLARKS SUMMIT
Mailing Address - State:PA
Mailing Address - Zip Code:18411-2269
Mailing Address - Country:US
Mailing Address - Phone:570-586-5687
Mailing Address - Fax:
Practice Address - Street 1:3 ABINGTON EXECUTIVE PARK STE 7
Practice Address - Street 2:
Practice Address - City:CLARKS SUMMIT
Practice Address - State:PA
Practice Address - Zip Code:18411-2269
Practice Address - Country:US
Practice Address - Phone:570-586-5687
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOHN SCHELAND, DPM P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-19
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018796800007Medicaid
PA69232OtherGEISINGER