Provider Demographics
NPI:1558337030
Name:CANLAS, JOLLY B (MD)
Entity Type:Individual
Prefix:DR
First Name:JOLLY
Middle Name:B
Last Name:CANLAS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3897 ADLER PL
Mailing Address - Street 2:BUILDING C SUITE 160
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-9425
Mailing Address - Country:US
Mailing Address - Phone:610-868-6830
Mailing Address - Fax:610-868-4654
Practice Address - Street 1:3897 ADLER PL
Practice Address - Street 2:BUILDING C SUITE 160
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-9425
Practice Address - Country:US
Practice Address - Phone:610-868-6830
Practice Address - Fax:610-868-4654
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-24
Last Update Date:2012-04-19
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Provider Licenses
StateLicense IDTaxonomies
PAMD033745E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine