Provider Demographics
NPI:1477752707
Name:RINKER, LORI ANN (DO)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ANN
Last Name:RINKER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:WATKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 DOCK HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17842-8910
Mailing Address - Country:US
Mailing Address - Phone:570-837-2123
Mailing Address - Fax:570-837-2185
Practice Address - Street 1:699 HASTINGS ST
Practice Address - Street 2:
Practice Address - City:S WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17702
Practice Address - Country:US
Practice Address - Phone:570-327-1335
Practice Address - Fax:570-321-7800
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS014721207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1025527680001Medicaid
PA194206F6KMedicare PIN
PA6465409OtherAETNA-PVN
50097370OtherCBC-KEYSTONE
PAOS014721OtherLICENSE