Provider Demographics
NPI:1346690864
Name:PATIENT FIRST PENNSYLVANIA MEDICAL GROUP PLLC
Entity Type:Organization
Organization Name:PATIENT FIRST PENNSYLVANIA MEDICAL GROUP PLLC
Other - Org Name:PATIENT FIRST - DEVON
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:H
Authorized Official - Last Name:MORISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-968-5700
Mailing Address - Street 1:5000 COX RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-9263
Mailing Address - Country:US
Mailing Address - Phone:804-822-4355
Mailing Address - Fax:
Practice Address - Street 1:133 LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:DEVON
Practice Address - State:PA
Practice Address - Zip Code:19333-1503
Practice Address - Country:US
Practice Address - Phone:484-581-2990
Practice Address - Fax:484-581-2991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-15
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA6531250015Medicare NSC
PA311498Medicare PIN