Provider Demographics
NPI:1467484592
Name:LANDIS, WILLIAM ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ALLEN
Last Name:LANDIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-4005
Mailing Address - Fax:717-812-2495
Practice Address - Street 1:1001 S GEORGE ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3676
Practice Address - Country:US
Practice Address - Phone:717-851-4005
Practice Address - Fax:717-812-2495
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039497L207R00000X, 207RG0300X
PAMD0349497L208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA30081OtherJOHNS HOPKINS
PA001086430Medicaid
MD543243OtherCAREFIRST MD BCBS
MD019992300Medicaid
PA20090441OtherAMERIHEALTH MERCY-WMG
PAP002893OtherGATEWAY-WMG (PCP)
PA181794OtherUNISON-WMG
PA2161248OtherMAMSI-WMG
PA30131980OtherAMERIHEALTH MERCY - WMG
PA50082044OtherCAPITAL BLUE CROSS-WMG GH
PA1551155OtherGATEWAY-WMG (HOSP)
PA192752OtherHIGHMARK BLUE SHIELD
PA01114402OtherCAPITAL BLUE CROSS-WMG
PA40177OtherGEISINGER
PA4589603OtherAETNA
PA1551155OtherGATEWAY-WMG (HOSP)
PA4589603OtherAETNA
PA40177OtherGEISINGER
PA192752EZ3Medicare PIN