Provider Demographics
NPI:1407097405
Name:GETTYSBURG OSTEOPATHIC FAMILY HEALTH CENTER PC
Entity Type:Organization
Organization Name:GETTYSBURG OSTEOPATHIC FAMILY HEALTH CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:MAUSS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:717-818-4100
Mailing Address - Street 1:400 OAK HILL RD
Mailing Address - Street 2:
Mailing Address - City:BIGLERVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17307-9785
Mailing Address - Country:US
Mailing Address - Phone:717-818-4100
Mailing Address - Fax:
Practice Address - Street 1:2311 FAIRFIELD RD
Practice Address - Street 2:SUITE E
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-6309
Practice Address - Country:US
Practice Address - Phone:717-818-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-20
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013224207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty