Provider Demographics
NPI:1447414701
Name:DONNA EGET PC
Entity Type:Organization
Organization Name:DONNA EGET PC
Other - Org Name:MEDICUS URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:EGET
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:570-207-2612
Mailing Address - Street 1:1208 ONEILL HWY
Mailing Address - Street 2:
Mailing Address - City:DUNMORE
Mailing Address - State:PA
Mailing Address - Zip Code:18512-1709
Mailing Address - Country:US
Mailing Address - Phone:570-207-2612
Mailing Address - Fax:570-207-2616
Practice Address - Street 1:1208 ONEILL HWY
Practice Address - Street 2:
Practice Address - City:DUNMORE
Practice Address - State:PA
Practice Address - Zip Code:18512-1709
Practice Address - Country:US
Practice Address - Phone:570-207-2612
Practice Address - Fax:570-207-2616
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DONNA EGET PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-16
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS008478L207P00000X
PA261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA144455Medicare PIN