Provider Demographics
NPI:1659633162
Name:FORNADLEY, JEFFREY MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:MICHAEL
Last Name:FORNADLEY
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Gender:M
Credentials:MD
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Mailing Address - Street 1:500 UNIVERSITY DR
Mailing Address - Street 2:DEPT OF SURGERY MC H159
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-2360
Mailing Address - Country:US
Mailing Address - Phone:717-531-8557
Mailing Address - Fax:717-531-5393
Practice Address - Street 1:500 UNIVERSITY DR
Practice Address - Street 2:DEPT OF SURGERY MC H159
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2360
Practice Address - Country:US
Practice Address - Phone:717-531-8557
Practice Address - Fax:717-531-5393
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2023-10-02
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Provider Licenses
StateLicense IDTaxonomies
PAMD471038208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery