Provider Demographics
NPI:1730145517
Name:SPIRIT PHYSICIAN SERVICES INC
Entity Type:Organization
Organization Name:SPIRIT PHYSICIAN SERVICES INC
Other - Org Name:HOLY SPIRIT FAMILY MEDICINE DUNCANNON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GATESMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-972-4480
Mailing Address - Street 1:205 GRANDVIEW AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-1708
Mailing Address - Country:US
Mailing Address - Phone:717-972-4480
Mailing Address - Fax:717-972-4470
Practice Address - Street 1:51 BUSINESS CAMPUS WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:DUNCANNON
Practice Address - State:PA
Practice Address - Zip Code:17020-9596
Practice Address - Country:US
Practice Address - Phone:717-834-3108
Practice Address - Fax:717-834-6911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-21
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty