Provider Demographics
NPI:1366479933
Name:RICH, JOHN T (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:RICH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:484-884-0699
Practice Address - Street 1:334 MAIN ST
Practice Address - Street 2:STE 1
Practice Address - City:DICKSON CITY
Practice Address - State:PA
Practice Address - Zip Code:18519-1620
Practice Address - Country:US
Practice Address - Phone:570-307-1767
Practice Address - Fax:570-307-1770
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2022-03-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD042840L207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF76912Medicare UPIN
PA022626Medicare ID - Type Unspecified