Provider Demographics
NPI:1487634291
Name:RICHARD D ALLATT MD PC
Entity Type:Organization
Organization Name:RICHARD D ALLATT MD PC
Other - Org Name:RICHARD D. ALLATT, MD, PC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:D
Authorized Official - Last Name:ALLATT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-359-5620
Mailing Address - Street 1:PO BOX 251
Mailing Address - Street 2:
Mailing Address - City:BOALSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16827-0000
Mailing Address - Country:US
Mailing Address - Phone:814-359-5620
Mailing Address - Fax:814-359-5629
Practice Address - Street 1:HEALTHSOUTH
Practice Address - Street 2:550 W COLLEGE AVE
Practice Address - City:PLEASANT GAP
Practice Address - State:PA
Practice Address - Zip Code:16823-0000
Practice Address - Country:US
Practice Address - Phone:814-359-5620
Practice Address - Fax:814-359-5629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-18
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA002649OtherHIGHMARK GROUP#
PA1007409100004Medicaid
PA02748200OtherCAPITAL BCBS GROUP#
PA1015OtherGEISINGER GROUP#
PACI7521OtherRAILROAD MEDICARE GROUP#
PA1015OtherGEISINGER GROUP#